1750916565 NPI number — CORRECTIONS AND REHABILITATION-HEADQUARTERS

Table of content: MARK NABEEL HAKIM M.D. (NPI 1144437526)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750916565 NPI number — CORRECTIONS AND REHABILITATION-HEADQUARTERS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CORRECTIONS AND REHABILITATION-HEADQUARTERS
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:
6
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:
1750916565
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/04/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1031
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TEHACHAPI
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93581-1031
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-622-4402
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24900 END OF HWY 202
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TEHACHAPI
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93561
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-822-4402
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/12/2020

Additional Information

Authorized Official

Authorized Official Last Name:
JAMES
Authorized Official First Name:
PIERRE
Authorized Official Middle Name:
CAESARE SAUCIER
Authorized Official Title or Position:
STAFF SERVICES MANAGER I
Authorized Official Telephone Number:
510-780-6997

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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