1780860866 NPI number — HEALTH NET LIFE INSURANCE COMPANY, CA PPO

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 1780860866 NPI number — HEALTH NET LIFE INSURANCE COMPANY, CA PPO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH NET LIFE INSURANCE COMPANY, CA PPO
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:
1780860866
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21650 OXNARD ST
Provider Second Line Business Mailing Address:
MAIL STOP: CA-102-22-12
Provider Business Mailing Address City Name:
WOODLAND HILLS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91367-4901
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-676-8767
Provider Business Mailing Address Fax Number:
818-676-7754

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21281 BURBANK BLVD
Provider Second Line Business Practice Location Address:
MAIL STOP: CA-900-03-31
Provider Business Practice Location Address City Name:
WOODLAND HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91367-6607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-676-8767
Provider Business Practice Location Address Fax Number:
818-676-7754
Provider Enumeration Date:
01/18/2008

Additional Information

Authorized Official

Authorized Official Last Name:
WOYS
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
E.
Authorized Official Title or Position:
PRESIDENT HEALTH NET LIFE INSURANCE
Authorized Official Telephone Number:
818-676-8454

Provider Taxonomy Codes

  • Taxonomy code: 305R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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