1699748301 NPI number — DR. RITA PARAISO GUIAMELON M.D.

Table of content: DR. RITA PARAISO GUIAMELON M.D. (NPI 1699748301)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699748301 NPI number — DR. RITA PARAISO GUIAMELON M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GUIAMELON
Provider First Name:
RITA
Provider Middle Name:
PARAISO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

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:
1699748301
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6130 BONNER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH HOLLYWOOD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91606-4918
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-980-6749
Provider Business Mailing Address Fax Number:
818-980-6749

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7301 SEPULVEDA BLVD
Provider Second Line Business Practice Location Address:
SUITE-3
Provider Business Practice Location Address City Name:
VAN NUYS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91405-1782
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-786-7710
Provider Business Practice Location Address Fax Number:
818-786-7711
Provider Enumeration Date:
02/12/2006

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: 208000000X , with the licence number:  A84265 , 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: 232930 . This is a "MEDICAL LICENSE NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: MD00040515 . This is a "MEDICAL LICENSE NUMBER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: A84265 . This is a "MEDICAL LICENSE NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com