1730222688 NPI number — UNITED STATES VETERANS INITIATIVE

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 1730222688 NPI number — UNITED STATES VETERANS INITIATIVE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNITED STATES VETERANS INITIATIVE
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:
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:
1730222688
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2001 RIVER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LONG BEACH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90810-3622
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-388-8016
Provider Business Mailing Address Fax Number:
562-388-7991

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2001 RIVER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90810-3622
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-388-8016
Provider Business Practice Location Address Fax Number:
562-388-7991
Provider Enumeration Date:
02/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MCCORMACK
Authorized Official First Name:
GREG
Authorized Official Middle Name:
Authorized Official Title or Position:
SITE DIRECTOR
Authorized Official Telephone Number:
562-388-8016

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; 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