1841566189 NPI number — MS. KATHLEEN BEAUFAIT L.AC.

Table of content: MS. KATHLEEN BEAUFAIT L.AC. (NPI 1841566189)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841566189 NPI number — MS. KATHLEEN BEAUFAIT L.AC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BEAUFAIT
Provider First Name:
KATHLEEN
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
L.AC.
Provider Gender Code:
F

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:
1841566189
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/02/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7740 REDLANDS ST
Provider Second Line Business Mailing Address:
#G2084
Provider Business Mailing Address City Name:
PLAYA DEL REY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90293-8452
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-420-8181
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20911 EARL ST
Provider Second Line Business Practice Location Address:
SUITE 330
Provider Business Practice Location Address City Name:
TORRANCE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90503-4352
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-540-0300
Provider Business Practice Location Address Fax Number:
310-542-5900
Provider Enumeration Date:
03/30/2012

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: 171100000X , with the licence number:  12166 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 235Z00000X , with the licence number: 3727 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





Copyright © 2007-2024 www.npivalidator.com