1942257795 NPI number — KINGI M LANGI PA.C, M.T.

Table of content: KINGI M LANGI PA.C, M.T. (NPI 1942257795)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942257795 NPI number — KINGI M LANGI PA.C, M.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LANGI
Provider First Name:
KINGI
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA.C, M.T.
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:
1942257795
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/18/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
313 E 900 S
Provider Second Line Business Mailing Address:
STE 102
Provider Business Mailing Address City Name:
SALT LAKE CITY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84111-4315
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-532-2265
Provider Business Mailing Address Fax Number:
801-532-2351

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
313 E 900 S
Provider Second Line Business Practice Location Address:
STE 102
Provider Business Practice Location Address City Name:
SALT LAKE CITY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84111-4315
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-532-2265
Provider Business Practice Location Address Fax Number:
801-532-2351
Provider Enumeration Date:
05/27/2006

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: 363A00000X , with the licence number:  1061331206 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 870460998008 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com