1487017026 NPI number — ASFON SERVICES INC

Table of content: (NPI 1487017026)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487017026 NPI number — ASFON SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASFON SERVICES 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:
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:
1487017026
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17511 SHERBROOK DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TUSTIN
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92780-2502
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-612-4042
Provider Business Mailing Address Fax Number:
949-271-4087

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12377 LEWIS ST
Provider Second Line Business Practice Location Address:
SUITE 201/205
Provider Business Practice Location Address City Name:
GARDEN GROVE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92840-4675
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-612-4042
Provider Business Practice Location Address Fax Number:
949-271-4087
Provider Enumeration Date:
03/31/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
NAWAZ
Authorized Official First Name:
FATHIMA
Authorized Official Middle Name:
RINOOZA
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
310-612-4042

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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