1780928655 NPI number — CENTER FOR INTEGRATED FAMILY AND HEALTH SERVICES

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 1780928655 NPI number — CENTER FOR INTEGRATED FAMILY AND HEALTH SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTER FOR INTEGRATED FAMILY AND HEALTH SERVICES
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:
FAMILY CENTER BALDWIN PARK HIGH SCHOOL
Provider Other Organization Name Type Code:
5
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:
1780928655
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/16/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3900 NORTH PUENTE AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALDWIN PARK
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91706-4428
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-967-5103
Provider Business Mailing Address Fax Number:
626-967-1339

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
560 S SAN JOSE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COVINA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91723-3144
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-967-5103
Provider Business Practice Location Address Fax Number:
626-967-1339
Provider Enumeration Date:
11/16/2012

Additional Information

Authorized Official

Authorized Official Last Name:
NIGH
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
L
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
626-966-1577

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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