1629473392 NPI number — WINDY PAGUIO SALES BUSINESS OWNER

Table of content: WINDY PAGUIO SALES BUSINESS OWNER (NPI 1629473392)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629473392 NPI number — WINDY PAGUIO SALES BUSINESS OWNER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SALES
Provider First Name:
WINDY
Provider Middle Name:
PAGUIO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
BUSINESS OWNER
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SPINOSA
Provider Other First Name:
WINDY
Provider Other Middle Name:
PAGUIO
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
BUSINESS OWNER
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1629473392
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/23/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
450 N BRAND BLVD
Provider Second Line Business Mailing Address:
STE. 600
Provider Business Mailing Address City Name:
GLENDALE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91203-2347
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-441-8418
Provider Business Mailing Address Fax Number:
818-291-6259

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
450 N BRAND BLVD
Provider Second Line Business Practice Location Address:
STE. 600
Provider Business Practice Location Address City Name:
GLENDALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91203-2347
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-441-8418
Provider Business Practice Location Address Fax Number:
818-291-6259
Provider Enumeration Date:
10/23/2014

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: 171M00000X , with the licence number:  471732998 , 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)





Copyright © 2007-2024 www.npivalidator.com