1972719763 NPI number — PINNACLE HEALTHCARE

Table of content: (NPI 1972719763)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972719763 NPI number — PINNACLE HEALTHCARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PINNACLE HEALTHCARE
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:
1972719763
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/07/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 ROSSI CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALINAS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93907-2370
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
831-770-0444
Provider Business Mailing Address Fax Number:
831-770-0445

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4 ROSSI CIR
Provider Second Line Business Practice Location Address:
141
Provider Business Practice Location Address City Name:
SALINAS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93907-2362
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
831-757-4444
Provider Business Practice Location Address Fax Number:
831-757-4419
Provider Enumeration Date:
05/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
NERVINO
Authorized Official First Name:
HARRY
Authorized Official Middle Name:
Authorized Official Title or Position:
DOCTOR
Authorized Official Telephone Number:
831-770-0444

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  A36694 , 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: A36694 . This is a "LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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