1861439846 NPI number — AUBREY C MEY

Table of content: AUBREY C MEY (NPI 1861439846)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861439846 NPI number — AUBREY C MEY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEY
Provider First Name:
AUBREY
Provider Middle Name:
C
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ANDREWS
Provider Other First Name:
AUBREY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1861439846
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/19/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5000 CHESHIRE PKWY N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLYMOUTH
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55446-4103
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
763-268-4115
Provider Business Mailing Address Fax Number:
763-268-4430

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2530 ATLANTIC AVE
Provider Second Line Business Practice Location Address:
STE D
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90806-2741
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-426-2137
Provider Business Practice Location Address Fax Number:
562-426-2512
Provider Enumeration Date:
05/31/2006

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: 237700000X , with the licence number:  HA6013 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237600000X , with the licence number: AU2357 , 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: AU0023570 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com