1841511987 NPI number — MRS. CARMELINE YVONNE GUALVEZ CAMPOS RPH

Table of content: MRS. CARMELINE YVONNE GUALVEZ CAMPOS RPH (NPI 1841511987)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841511987 NPI number — MRS. CARMELINE YVONNE GUALVEZ CAMPOS RPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CAMPOS
Provider First Name:
CARMELINE YVONNE
Provider Middle Name:
GUALVEZ
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RPH
Provider Gender Code:
F

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:
1841511987
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/11/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26991 TIMBERLINE TER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VALENCIA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91381-0622
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-287-3905
Provider Business Mailing Address Fax Number:
661-799-2767

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7239 WOODMAN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VAN NUYS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91405-2621
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-781-7127
Provider Business Practice Location Address Fax Number:
818-781-9148
Provider Enumeration Date:
06/11/2010

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: 183500000X , with the licence number:  RH46618 , 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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