1548310634 NPI number — STUART R WINTHROP MD INC

Table of content: (NPI 1548310634)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548310634 NPI number — STUART R WINTHROP MD INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STUART R WINTHROP MD INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
STUART R WINTHROP MD INC
Provider Other Organization Name Type Code:
3
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:
1548310634
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
515 E MICHELTORENA ST
Provider Second Line Business Mailing Address:
SUITE D
Provider Business Mailing Address City Name:
SANTA BARBARA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93103-2257
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-963-4272
Provider Business Mailing Address Fax Number:
805-962-7342

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
515 E MICHELTORENA ST
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
SANTA BARBARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93103-2257
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-963-4272
Provider Business Practice Location Address Fax Number:
805-962-7342
Provider Enumeration Date:
01/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WINTHROP
Authorized Official First Name:
STUART
Authorized Official Middle Name:
R
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
805-963-4272

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  G34164 , 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)

  • Identifier: 539238 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 7003358 . This is a "MAMSI LIFE & HEALTH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 7102000CA . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: CA34164 . This is a "MUTUAL OF OMAHA" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 0665290001 . This is a "AETNA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 4485 . This is a "MEDICAL EYE SERVICES" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: G34164 . This is a "BLUE CROSS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: GR0067800 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: ZZZ42428Z . This is a "BLUE SHIELD" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: CD5255 . This is a "RR MEDICARE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 000009998 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com