1437160926 NPI number — KARE FOODS INC

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 1437160926 NPI number — KARE FOODS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KARE FOODS INC
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:
6
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:
1437160926
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/01/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11309 VENTURA BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STUDIO CITY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91604-3188
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-506-0776
Provider Business Mailing Address Fax Number:
818-506-9055

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11309 VENTURA BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STUDIO CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91604-3188
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-506-0776
Provider Business Practice Location Address Fax Number:
818-506-9055
Provider Enumeration Date:
08/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TABAKIAN
Authorized Official First Name:
VARTAN
Authorized Official Middle Name:
V
Authorized Official Title or Position:
PRES
Authorized Official Telephone Number:
818-506-0776

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  PHY 51656 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BP3500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: PHY 51656 , 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: PHA462720 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: PHY 51656 . This is a "CALIFORNIA STATE BOARD OF PHARMACY PERMIT" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1437160926 . This is a "MEDI-CAL PROVIDER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1998962 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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