1285704841 NPI number — MRS. MARGARET MARINELL PALMER OTRL

Table of content: MRS. MARGARET MARINELL PALMER OTRL (NPI 1285704841)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285704841 NPI number — MRS. MARGARET MARINELL PALMER OTRL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PALMER
Provider First Name:
MARGARET
Provider Middle Name:
MARINELL
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
OTRL
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PALMR
Provider Other First Name:
MEG
Provider Other Middle Name:
M.
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
OTRL
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1285704841
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
815 PALMER HILL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PARADISE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95969-6385
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
530-877-5071
Provider Business Mailing Address Fax Number:
530-877-5071

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2404 MARIGOLD AVE
Provider Second Line Business Practice Location Address:
LOMA VISTA MTU
Provider Business Practice Location Address City Name:
CHICO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95926-1615
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-879-7408
Provider Business Practice Location Address Fax Number:
530-895-6640
Provider Enumeration Date:
11/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225XP0200X , with the licence number:  OT 1043 , 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: CGP169164 . This is a "CCS PANEL PROVIDER NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: PF0989 . This is a "FNRC VENDOR NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 377739 . This is a "AMERICAN OT ASSOCIATION" identifier . This identifiers is of the category "OTHER".




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