1740517952 NPI number — BRADEN PARNTERS LP

Table of content: (NPI 1740517952)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740517952 NPI number — BRADEN PARNTERS LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRADEN PARNTERS LP
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:
PACIFIC PULMONARY SERVICES
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:
1740517952
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/09/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4300 STINE RD.
Provider Second Line Business Mailing Address:
STE 800
Provider Business Mailing Address City Name:
BAKERSFIELD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93313-2354
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-396-3720
Provider Business Mailing Address Fax Number:
660-832-6010

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1340 CHERRY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HELENA
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59601-0610
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-442-2491
Provider Business Practice Location Address Fax Number:
406-449-2562
Provider Enumeration Date:
11/09/2009

Additional Information

Authorized Official

Authorized Official Last Name:
MARTIN
Authorized Official First Name:
CHAD
Authorized Official Middle Name:
H
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
415-893-1518

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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