1073827242 NPI number — ASIAN HEALTH SERVICES

Table of content: (NPI 1073827242)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073827242 NPI number — ASIAN HEALTH SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASIAN HEALTH SERVICES
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:
1073827242
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/02/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 8TH ST STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAKLAND
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94607-4707
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-735-3100
Provider Business Mailing Address Fax Number:
510-735-3299

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
817 HARRISON STREET
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:
94607-4422
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-986-0430
Provider Business Practice Location Address Fax Number:
510-986-0572
Provider Enumeration Date:
07/30/2010

Additional Information

Authorized Official

Authorized Official Last Name:
LEE
Authorized Official First Name:
GEORGE
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
510-986-6830

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X , with the licence number:  140000125 , 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: 1447391719 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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