1245294644 NPI number — ROYALTY NEPHROLOGY MEDICAL GROUP, INC.

Table of content: ERIKA CARTER TOWNSEND RN (NPI 1275125601)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245294644 NPI number — ROYALTY NEPHROLOGY MEDICAL GROUP, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROYALTY NEPHROLOGY MEDICAL GROUP, 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:
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:
1245294644
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1900 ROYALTY DR
Provider Second Line Business Mailing Address:
SUITE 130
Provider Business Mailing Address City Name:
POMONA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91767-3032
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-623-1561
Provider Business Mailing Address Fax Number:
909-629-1418

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1900 ROYALTY DR
Provider Second Line Business Practice Location Address:
SUITE 130
Provider Business Practice Location Address City Name:
POMONA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91767-3032
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-623-1561
Provider Business Practice Location Address Fax Number:
909-629-1418
Provider Enumeration Date:
04/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PAPPOE
Authorized Official First Name:
VICTOR
Authorized Official Middle Name:
L
Authorized Official Title or Position:
MD/PRESIDENT
Authorized Official Telephone Number:
909-623-1561

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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