1841278447 NPI number — BERNARD M DIAMOND MD INC

Table of content: DR. PENNY SUE FLURY D.D.S. (NPI 1538148788)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841278447 NPI number — BERNARD M DIAMOND MD INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BERNARD M DIAMOND 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:
WEST VALLEY ORTHOPAEDIC & SPORTS MEDICINE 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:
1841278447
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/02/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23101 SHERMAN PL
Provider Second Line Business Mailing Address:
STE 210
Provider Business Mailing Address City Name:
WEST HILLS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91307-2003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-348-4110
Provider Business Mailing Address Fax Number:
818-348-4208

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23101 SHERMAN PL
Provider Second Line Business Practice Location Address:
STE 210
Provider Business Practice Location Address City Name:
WEST HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91307-2003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-348-4110
Provider Business Practice Location Address Fax Number:
818-348-4208
Provider Enumeration Date:
01/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DIAMOND
Authorized Official First Name:
BERNARD
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
818-348-4110

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: W18224 . This is a "MEDICARE SUBMITTER NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com