1275851859 NPI number — PLAZA DE NUESTRA COMUNIDAD

Table of content: (NPI 1275851859)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275851859 NPI number — PLAZA DE NUESTRA COMUNIDAD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PLAZA DE NUESTRA COMUNIDAD
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:
1275851859
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/16/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
195 W 12TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EUGENE
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97401-3408
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-687-2667
Provider Business Mailing Address Fax Number:
541-284-2139

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
195 W 12TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EUGENE
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97401-3408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-687-2667
Provider Business Practice Location Address Fax Number:
541-284-2139
Provider Enumeration Date:
05/06/2010

Additional Information

Authorized Official

Authorized Official Last Name:
SAEZ
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
Authorized Official Title or Position:
CO-EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
541-687-2667

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 163WA0400X . This is a "HIPAA" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".




Copyright © 2007-2026 www.npivalidator.com