1417197039 NPI number — ORTHOPEDIC HOSPITALISTS OF AUBURN, PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417197039 NPI number — ORTHOPEDIC HOSPITALISTS OF AUBURN, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORTHOPEDIC HOSPITALISTS OF AUBURN, PC
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:
1417197039
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/19/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 79695
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CITY OF INDUSTRY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91716-9695
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-470-3700
Provider Business Mailing Address Fax Number:
330-497-7940

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
202 N DIVISION ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98001-4939
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-333-2535
Provider Business Practice Location Address Fax Number:
235-804-2805
Provider Enumeration Date:
02/22/2009

Additional Information

Authorized Official

Authorized Official Last Name:
GAGLIARDI
Authorized Official First Name:
MARTIN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
866-885-5522

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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