1891852067 NPI number — DR. THOMAS STANLEY BAKMAN D.C.

Table of content: DR. THOMAS STANLEY BAKMAN D.C. (NPI 1891852067)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891852067 NPI number — DR. THOMAS STANLEY BAKMAN D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAKMAN
Provider First Name:
THOMAS
Provider Middle Name:
STANLEY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NONE
Provider Other First Name:
NONE
Provider Other Middle Name:
NONE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.C.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1891852067
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/17/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
18818 TELLER AVE
Provider Second Line Business Mailing Address:
SUITE 170
Provider Business Mailing Address City Name:
IRVINE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92612-1678
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-535-2322
Provider Business Mailing Address Fax Number:
949-535-2330

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18818 TELLER AVE
Provider Second Line Business Practice Location Address:
SUITE 170
Provider Business Practice Location Address City Name:
IRVINE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92612-1678
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-535-2322
Provider Business Practice Location Address Fax Number:
949-535-2330
Provider Enumeration Date:
01/03/2007

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: 111NS0005X , with the licence number:  19041 , 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: 47-1674398 . This is a "TAX ID" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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