1073820981 NPI number — ARVIN ORINA DEL SOCORRO

Table of content: ARVIN ORINA DEL SOCORRO (NPI 1073820981)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073820981 NPI number — ARVIN ORINA DEL SOCORRO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DEL SOCORRO
Provider First Name:
ARVIN
Provider Middle Name:
ORINA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

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:
1073820981
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/13/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1385 MISSION ST
Provider Second Line Business Mailing Address:
SUITE 240
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94103-2623
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-864-4002
Provider Business Mailing Address Fax Number:
415-864-7093

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1385 MISSION ST
Provider Second Line Business Practice Location Address:
SUITE 240
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94103-2623
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-864-4002
Provider Business Practice Location Address Fax Number:
415-864-7093
Provider Enumeration Date:
09/13/2010

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: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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