1467605998 NPI number — DIANNE CHERYL ESPLIN R.D.

Table of content: (NPI 1982987251)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467605998 NPI number — DIANNE CHERYL ESPLIN R.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ESPLIN
Provider First Name:
DIANNE
Provider Middle Name:
CHERYL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
R.D.
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:
1467605998
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 500938
Provider Second Line Business Mailing Address:
MEDICAL ASSOCIATES OF THE PACIFIC
Provider Business Mailing Address City Name:
SAIPAN
Provider Business Mailing Address State Name:
MP
Provider Business Mailing Address Postal Code:
96950-0938
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
670-323-9000
Provider Business Mailing Address Fax Number:
670-323-9010

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
MH II BUILDING SUITE 101
Provider Second Line Business Practice Location Address:
MARIANAS BUSINESS PARK
Provider Business Practice Location Address City Name:
SAIPAN
Provider Business Practice Location Address State Name:
MP
Provider Business Practice Location Address Postal Code:
96950
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
670-323-9000
Provider Business Practice Location Address Fax Number:
670-323-9010
Provider Enumeration Date:
10/28/2008

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: 133V00000X , with the licence number:  724945 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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