1215372909 NPI number — NADIA KHALIL THALJI MA AND PH.D STUDENT

Table of content: NADIA KHALIL THALJI MA AND PH.D STUDENT (NPI 1215372909)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215372909 NPI number — NADIA KHALIL THALJI MA AND PH.D STUDENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
THALJI
Provider First Name:
NADIA
Provider Middle Name:
KHALIL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA AND PH.D STUDENT
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:
1215372909
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/08/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
36 N CLAREMONT ST
Provider Second Line Business Mailing Address:
APT 5
Provider Business Mailing Address City Name:
SAN MATEO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94401-3270
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-379-8114
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1330 LINCOLN AVE
Provider Second Line Business Practice Location Address:
201
Provider Business Practice Location Address City Name:
SAN RAFAEL
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94901-2120
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-459-5999
Provider Business Practice Location Address Fax Number:
415-459-5602
Provider Enumeration Date:
05/08/2013

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com