1427216621 NPI number — MRS. JOSEPHINA OLARITA DHUNGANA MFC

Table of content: MRS. JOSEPHINA OLARITA DHUNGANA MFC (NPI 1427216621)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427216621 NPI number — MRS. JOSEPHINA OLARITA DHUNGANA MFC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DHUNGANA
Provider First Name:
JOSEPHINA
Provider Middle Name:
OLARITA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MFC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DHUNGANA
Provider Other First Name:
JOSEFINA
Provider Other Middle Name:
OLARITA
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1427216621
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/26/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2070 261ST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOMITA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90717-3216
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-530-4167
Provider Business Mailing Address Fax Number:
310-513-6766

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
149 PALOS VERDES BLVD
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
REDONDO BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90277-5800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-374-7407
Provider Business Practice Location Address Fax Number:
310-318-6626
Provider Enumeration Date:
05/26/2008

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: 106H00000X , with the licence number:  MFC 45422 , 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)





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