1699120865 NPI number — CHRISTINA SIELBECK VIMINI R.D.

Table of content: CHRISTINA SIELBECK VIMINI R.D. (NPI 1699120865)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699120865 NPI number — CHRISTINA SIELBECK VIMINI R.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VIMINI
Provider First Name:
CHRISTINA
Provider Middle Name:
SIELBECK
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
R.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SIELBECK
Provider Other First Name:
CHRISTINA
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1699120865
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/18/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1976 WRIGHT AVE
Provider Second Line Business Mailing Address:
UNIT 102
Provider Business Mailing Address City Name:
WAHIAWA
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96786-6146
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:
91-2127 FORT WEAVER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EWA BEACH
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96706-1993
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-691-3370
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/25/2016

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: 133V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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