1801007174 NPI number — JON G FINKLER MD

Table of content: JON G FINKLER MD (NPI 1801007174)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801007174 NPI number — JON G FINKLER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FINKLER
Provider First Name:
JON
Provider Middle Name:
G
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1801007174
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:
2200 SUNRISE BLVD
Provider Second Line Business Mailing Address:
SUITE #250
Provider Business Mailing Address City Name:
GOLD RIVER
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95670-4374
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-851-8400
Provider Business Mailing Address Fax Number:
916-851-9117

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2200 SUNRISE BLVD
Provider Second Line Business Practice Location Address:
SUITE #250
Provider Business Practice Location Address City Name:
GOLD RIVER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95670-4374
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-851-8400
Provider Business Practice Location Address Fax Number:
916-851-9117
Provider Enumeration Date:
05/25/2007

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: 208600000X , with the licence number:  C37064 , 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)

  • Identifier: C37064 . This is a "MED LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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