1871984633 NPI number — VALLEY WHOLISTIC HEALTH CENTER

Table of content: DR. TIMOTHY MICHAEL BIZGA D.D.S. (NPI 1750622676)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871984633 NPI number — VALLEY WHOLISTIC HEALTH CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VALLEY WHOLISTIC HEALTH CENTER
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:
1871984633
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/13/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22030 CLARENDON ST
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
WOODLAND HILLS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91367-6316
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-887-4000
Provider Business Mailing Address Fax Number:
818-332-4133

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
22030 CLARENDON ST
Provider Second Line Business Practice Location Address:
101
Provider Business Practice Location Address City Name:
WOODLAND HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91367-6316
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-887-4000
Provider Business Practice Location Address Fax Number:
818-332-4133
Provider Enumeration Date:
02/13/2015

Additional Information

Authorized Official

Authorized Official Last Name:
HUMMEL
Authorized Official First Name:
KEVIN
Authorized Official Middle Name:
LANE
Authorized Official Title or Position:
CHIROPRACTOR
Authorized Official Telephone Number:
818-887-4000

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  33149 , 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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