1265765556 NPI number — ALGT,LLC

Table of content: (NPI 1265765556)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265765556 NPI number — ALGT,LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALGT,LLC
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:
1265765556
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/04/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
28202 CABOT RD
Provider Second Line Business Mailing Address:
412
Provider Business Mailing Address City Name:
LAGUNA NIGUEL
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92677-1222
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-347-7100
Provider Business Mailing Address Fax Number:
949-347-7800

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14966 TERRENO DE FLORES LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS GATOS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95032-2023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-347-7100
Provider Business Practice Location Address Fax Number:
949-347-7800
Provider Enumeration Date:
09/17/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BRADSHAW
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
JARED
Authorized Official Title or Position:
SECRETARY/VP OPERATIONS
Authorized Official Telephone Number:
714-548-8046

Provider Taxonomy Codes

  • Taxonomy code: 314000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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