1447405303 NPI number — BELLA LACHICA HOSTAK PT, DPT, GCS, CEEAA,

Table of content: BELLA LACHICA HOSTAK PT, DPT, GCS, CEEAA, (NPI 1447405303)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447405303 NPI number — BELLA LACHICA HOSTAK PT, DPT, GCS, CEEAA,

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOSTAK
Provider First Name:
BELLA
Provider Middle Name:
LACHICA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT, DPT, GCS, CEEAA,
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GOPLEN
Provider Other First Name:
BELLA
Provider Other Middle Name:
LACHICA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT, DPT, GCS, CEEAA,
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1447405303
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/16/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
809 BROADWAY ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KING CITY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93930
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
831-385-6835
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SALINAS VALLEY MEMORIAL HOSPITAL 450 E ROMIE LANE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALINAS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-750-9006
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/19/2008

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: 225100000X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: PT18891 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225100000X , with the licence number: PT27435 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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