1437388238 NPI number — ASFC,LLC

Table of content: (NPI 1437388238)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437388238 NPI number — ASFC,LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASFC,LLC
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:
SIERRA VISTA HEALTHCARE
Provider Other Organization Name Type Code:
3
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:
1437388238
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/29/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1715 S CEDAR AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRESNO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93702-4331
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-237-8377
Provider Business Mailing Address Fax Number:
559-485-5768

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1715 S CEDAR AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93702-4331
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-548-8046
Provider Business Practice Location Address Fax Number:
714-388-3632
Provider Enumeration Date:
07/14/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BRADSHAW
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
JARED
Authorized Official Title or Position:
SECRETARY
Authorized Official Telephone Number:
559-237-8377

Provider Taxonomy Codes

  • Taxonomy code: 314000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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