1013156520 NPI number — JANICE L. HULL, M.D., INC.

Table of content: (NPI 1013156520)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013156520 NPI number — JANICE L. HULL, M.D., INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JANICE L. HULL, M.D., INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
JANICE L. HULL, M.D.
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013156520
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/08/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2116
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INGLEWOOD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90305-0116
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8475 S VAN NESS AVE
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
INGLEWOOD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90305-1562
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-778-7990
Provider Business Practice Location Address Fax Number:
323-778-2486
Provider Enumeration Date:
02/08/2009

Additional Information

Authorized Official

Authorized Official Last Name:
HULL
Authorized Official First Name:
JANICE
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
323-778-7990

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  A80999 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00A809990 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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