1538151543 NPI number — PAUL CATTAFI DO

Table of content: PAUL CATTAFI DO (NPI 1538151543)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538151543 NPI number — PAUL CATTAFI DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CATTAFI
Provider First Name:
PAUL
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

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:
1538151543
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/15/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3626 RUFFIN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN DIEGO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92123-1810
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
858-565-9666
Provider Business Mailing Address Fax Number:
858-565-9441

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3626 RUFFIN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-565-9666
Provider Business Practice Location Address Fax Number:
858-565-9441
Provider Enumeration Date:
08/16/2005

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: 207L00000X , with the licence number:  Q5984 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207L00000X , with the licence number: 25MB07481600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: MB074816 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207L00000X , with the licence number: 20A15990 , 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)

  • Identifier: 5585887 . This is a "CCN NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01000735200 . This is a "AMERICHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2278427 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 365234901 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3691578 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8017348 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2012134210001 . This is a "SAINT BARNABAS HEALTH SYS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8221553 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8FR707 . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0047180 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 201213421 . This is a "BLUE CROSS/BLUE SHIELD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2469691 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 692847 . This is a "NCCPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 12249306 . This is a "MULTI PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7506618 . This is a "AETNA TRADITIONAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: P3471939 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60015949 . This is a "NJ HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2K5476 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2374965000 . This is a "AMERIHEALTH" identifier . This identifiers is of the category "OTHER".




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