1861933897 NPI number — OPERATION SAMAHAN INC

Table of content: (NPI 1861933897)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861933897 NPI number — OPERATION SAMAHAN INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OPERATION SAMAHAN INC
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:
Provider Other Organization Name Type Code:
6
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:
1861933897
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/19/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1428 HIGHLAND AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NATIONAL CITY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91950-4624
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
844-200-2426
Provider Business Mailing Address Fax Number:
619-474-4008

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9855 ERMA RD
Provider Second Line Business Practice Location Address:
SUITE 105 & 106
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92131-3001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
844-200-2426
Provider Business Practice Location Address Fax Number:
858-578-4417
Provider Enumeration Date:
03/09/2017

Additional Information

Authorized Official

Authorized Official Last Name:
BELLA
Authorized Official First Name:
ARCHIE
Authorized Official Middle Name:
P.
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
844-200-2426

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: BPSH80018226 . This is a "HRSA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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