1023296555 NPI number — NMRR INC

Table of content: DR. DEMIAN IBRAHIM NAGUIB M.D. (NPI 1285600296)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023296555 NPI number — NMRR INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NMRR 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:
6
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:
1023296555
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/06/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3746 MT DIABLO BLVD
Provider Second Line Business Mailing Address:
STE 204
Provider Business Mailing Address City Name:
LAFAYETTE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94549-3680
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
925-284-8888
Provider Business Mailing Address Fax Number:
925-284-8828

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7237 SKYLINE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94611-1120
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-338-0419
Provider Business Practice Location Address Fax Number:
510-338-0429
Provider Enumeration Date:
02/06/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SHRINER
Authorized Official First Name:
MATTHEW
Authorized Official Middle Name:
R
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
925-284-8888

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , 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)