1619995859 NPI number — JAMES R. ZIEGENBEIN, M.D., INC

Table of content: (NPI 1619995859)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619995859 NPI number — JAMES R. ZIEGENBEIN, M.D., INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JAMES R. ZIEGENBEIN, M.D., 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:
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:
1619995859
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P. O. BOX 90125
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LONG BEACH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90809-0125
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-404-2353
Provider Business Mailing Address Fax Number:
562-795-0676

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10267 NEWVILLE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOWNEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90241
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-861-6405
Provider Business Practice Location Address Fax Number:
564-861-6405
Provider Enumeration Date:
07/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ZIEGENBEIN
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
R
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
562-861-6405

Provider Taxonomy Codes

  • Taxonomy code: 207RI0200X , with the licence number:  G68469 , 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: 00G684690 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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