1518265131 NPI number — DR. NINA PAMELA ALMEDA SANTOS DO

Table of content: DR. NINA PAMELA ALMEDA SANTOS DO (NPI 1518265131)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518265131 NPI number — DR. NINA PAMELA ALMEDA SANTOS DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SANTOS
Provider First Name:
NINA PAMELA
Provider Middle Name:
ALMEDA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SANTOS
Provider Other First Name:
NINA
Provider Other Middle Name:
ALMEDA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DO
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1518265131
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/05/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
770 THE CITY DR S STE 4000
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORANGE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92868-4929
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-463-6628
Provider Business Mailing Address Fax Number:
714-620-3008

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 W CALIFORNIA BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PASADENA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91105-3010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-397-5000
Provider Business Practice Location Address Fax Number:
626-397-2968
Provider Enumeration Date:
03/07/2011

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: 208000000X , with the licence number:  15646 , 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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