1518290220 NPI number — MAXIN HEALTH CARE SERVICES INC.

Table of content: DR. SARA D. SHAW AU.D (NPI 1396033791)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518290220 NPI number — MAXIN HEALTH CARE SERVICES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MAXIN HEALTH CARE 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:
1518290220
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/14/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13508 ARCTURUS AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GARDENA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90249-2311
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-941-2276
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3756 SANTA ROSALIA DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90008-3606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-941-2276
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/14/2009

Additional Information

Authorized Official

Authorized Official Last Name:
NJOKU
Authorized Official First Name:
MARCEL
Authorized Official Middle Name:
CHIDI
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
310-941-2276

Provider Taxonomy Codes

  • Taxonomy code: 261QR0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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