1467820373 NPI number — JEFF HENRY 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 1467820373 NPI number — JEFF HENRY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JEFF HENRY 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:
1467820373
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/09/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7342 ORANGETHORPE AVE
Provider Second Line Business Mailing Address:
SUITE B-109
Provider Business Mailing Address City Name:
BUENA PARK
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90621-3326
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-521-1337
Provider Business Mailing Address Fax Number:
714-521-1338

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7342 ORANGETHORPE AVE
Provider Second Line Business Practice Location Address:
SUITE B-109
Provider Business Practice Location Address City Name:
BUENA PARK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90621-3326
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-521-1337
Provider Business Practice Location Address Fax Number:
714-521-1338
Provider Enumeration Date:
09/09/2015

Additional Information

Authorized Official

Authorized Official Last Name:
HENRY
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
ALAN
Authorized Official Title or Position:
GENERAL MANAGER
Authorized Official Telephone Number:
714-521-1337

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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