1801007083 NPI number — MS. BARBARA GLORIA MORITA P.A.

Table of content: MS. BARBARA GLORIA MORITA P.A. (NPI 1801007083)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801007083 NPI number — MS. BARBARA GLORIA MORITA P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORITA
Provider First Name:
BARBARA
Provider Middle Name:
GLORIA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
P.A.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MORITA-WAKE
Provider Other First Name:
BARBARA
Provider Other Middle Name:
GLORIA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
P.A.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1801007083
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1154 HOPKINS ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BERKELEY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94702-1358
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-524-3531
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
UNIVERSITY HEALTH SERVICES
Provider Second Line Business Practice Location Address:
2222 BANCROFT WAY
Provider Business Practice Location Address City Name:
BERKELEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94720-4300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-642-2000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  PA10473 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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