1346434297 NPI number — MS. SUHEIR KILANI PA-C

Table of content: MS. SUHEIR KILANI PA-C (NPI 1346434297)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346434297 NPI number — MS. SUHEIR KILANI PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KILANI
Provider First Name:
SUHEIR
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

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:
1346434297
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/24/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6535 MONTAIRE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LA PALMA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90623-1057
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-610-2584
Provider Business Mailing Address Fax Number:
877-306-3061

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9918 KATELLA AVE
Provider Second Line Business Practice Location Address:
C
Provider Business Practice Location Address City Name:
ANAHEIM
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92804-6465
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-625-8320
Provider Business Practice Location Address Fax Number:
714-583-7660
Provider Enumeration Date:
09/04/2007

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: 363AM0700X , with the licence number:  18023 , 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: 18023 . This is a "LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com