1033154182 NPI number — DR. ISABEL PURI MD

Table of content: DR. ISABEL PURI MD (NPI 1033154182)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033154182 NPI number — DR. ISABEL PURI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PURI
Provider First Name:
ISABEL
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1033154182
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21 BUGGY WHIP DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROLLING HILLS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90274-5008
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
858-382-1407
Provider Business Mailing Address Fax Number:
310-257-5753

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3333 SKYPARK DR
Provider Second Line Business Practice Location Address:
220
Provider Business Practice Location Address City Name:
TORRANCE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90505-5023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-257-5750
Provider Business Practice Location Address Fax Number:
310-257-5753
Provider Enumeration Date:
06/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  C43273 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2084P0804X , with the licence number: C43273 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





Copyright © 2007-2024 www.npivalidator.com