1639546583 NPI number — AFFINITY GROUP, LLC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639546583 NPI number — AFFINITY GROUP, LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AFFINITY GROUP, LLC.
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:
AFFINITY RECOVERY
Provider Other Organization Name Type Code:
3
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:
1639546583
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/26/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
18201 VON KARMAN AVE
Provider Second Line Business Mailing Address:
SUITE 330
Provider Business Mailing Address City Name:
IRVINE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92612-1000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
31952 PASEO TERRAZA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN JUAN CAPISTRANO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92675-3026
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-722-0112
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/26/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RABINOWITZ
Authorized Official First Name:
EVAN
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
714-722-0112

Provider Taxonomy Codes

  • Taxonomy code: 324500000X , with the licence number:  300330AP , 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)