1124173729 NPI number — DR. DARREN C CHERRY DO

Table of content: DR. DARREN C CHERRY DO (NPI 1124173729)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124173729 NPI number — DR. DARREN C CHERRY DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHERRY
Provider First Name:
DARREN
Provider Middle Name:
C
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

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:
1124173729
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/01/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
MWSS-374
Provider Second Line Business Mailing Address:
BOX 788285, MCAGCC 29 PALMS
Provider Business Mailing Address City Name:
TWENTYNINE PALMS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92278-8285
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-830-7475
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HOSPITAL AMERICANO BASE NAVAL DE ROTA
Provider Second Line Business Practice Location Address:
APARTADO DE CORREOS 33
Provider Business Practice Location Address City Name:
ROTA
Provider Business Practice Location Address State Name:
CADIZ
Provider Business Practice Location Address Postal Code:
11530
Provider Business Practice Location Address Country Code:
ES
Provider Business Practice Location Address Telephone Number:
760-799-0152
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/24/2007

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: 208D00000X , with the licence number:  0102201776 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207P00000X , with the licence number: 0102201776 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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