1093945305 NPI number — CHULA RAMA, INC.

Table of content: MELISSA SCHUECKLER CSAC (NPI 1710622626)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093945305 NPI number — CHULA RAMA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHULA RAMA, 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:
1093945305
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3020 OLD RANCH PKWY
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
SEAL BEACH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90740-2765
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-864-1252
Provider Business Mailing Address Fax Number:
562-799-5501

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3020 OLD RANCH PKWY
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
SEAL BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90740-2765
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-864-1252
Provider Business Practice Location Address Fax Number:
562-799-5501
Provider Enumeration Date:
07/21/2009

Additional Information

Authorized Official

Authorized Official Last Name:
CHEN
Authorized Official First Name:
YICHIA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
626-864-1252

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: NA , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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