1659472538 NPI number — JEF SAUNDERS PAC

Table of content: JEF SAUNDERS PAC (NPI 1659472538)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659472538 NPI number — JEF SAUNDERS PAC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAUNDERS
Provider First Name:
JEF
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PAC
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:
1659472538
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/18/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
447 OLD NEWPORT BLVD
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
NEWPORT BEACH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92663-4257
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-650-3350
Provider Business Mailing Address Fax Number:
949-650-1274

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
301 S 7TH AVE STE 1120
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST READING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19611-1493
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-628-0580
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/26/2006

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: 363AS0400X , with the licence number:  PA19863 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363AS0400X , with the licence number: MA052715 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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