1043229263 NPI number — CREATING HARMONY WOMEN'S HEALTHCARE INC

Table of content: (NPI 1043229263)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043229263 NPI number — CREATING HARMONY WOMEN'S HEALTHCARE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CREATING HARMONY WOMEN'S HEALTHCARE 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:
CREATING HARMONY WOMEN'S HEALTHCARE
Provider Other Organization Name Type Code:
5
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:
1043229263
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/19/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1941 JOHNSON AVE
Provider Second Line Business Mailing Address:
SUITE #202
Provider Business Mailing Address City Name:
SAN LUIS OBISPO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93401-4140
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-548-0033
Provider Business Mailing Address Fax Number:
805-548-0034

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1941 JOHNSON AVE
Provider Second Line Business Practice Location Address:
SUITE #202
Provider Business Practice Location Address City Name:
SAN LUIS OBISPO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93401-4140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-548-0033
Provider Business Practice Location Address Fax Number:
805-548-0034
Provider Enumeration Date:
08/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KROMHOUT
Authorized Official First Name:
AARON
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
805-548-0033

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  A88432 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LW0102X , with the licence number: 7319 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367A00000X , with the licence number: 1041 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367A00000X , with the licence number: 430 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367A00000X , with the licence number: 1530 , 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)





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