1508226929 NPI number — CHRISTINE TACOTACO ESPIRITU DPT

Table of content: CHRISTINE TACOTACO ESPIRITU DPT (NPI 1508226929)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508226929 NPI number — CHRISTINE TACOTACO ESPIRITU DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TACOTACO ESPIRITU
Provider First Name:
CHRISTINE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DPT
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:
1508226929
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/26/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
281 AUTUMN DR
Provider Second Line Business Mailing Address:
#239
Provider Business Mailing Address City Name:
SAN MARCOS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92069-2885
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
209-740-2704
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1958 VIA CTR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VISTA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92081-6056
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-477-1350
Provider Business Practice Location Address Fax Number:
760-754-6785
Provider Enumeration Date:
02/26/2016

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: 2251X0800X , with the licence number:  291169 , 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)





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