1942623657 NPI number — DAP HEALTH, INC.

Table of content: (NPI 1942623657)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942623657 NPI number — DAP HEALTH, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAP HEALTH, 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:
DAP HEALTH-ANZA COMMUNITY HEALTH CENTER
Provider Other Organization Name Type Code:
3
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:
1942623657
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/08/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1695 N. SUNRISE WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PALM SPRINGS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92262
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-323-2118
Provider Business Mailing Address Fax Number:
760-767-4552

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
58581 US HIGHWAY 371
Provider Second Line Business Practice Location Address:
SUITES F, G, & H
Provider Business Practice Location Address City Name:
ANZA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92539
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-344-2815
Provider Business Practice Location Address Fax Number:
619-398-2412
Provider Enumeration Date:
01/31/2014

Additional Information

Authorized Official

Authorized Official Last Name:
STITH
Authorized Official First Name:
JUDY
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF ADMINISTRATIVE OFFICER
Authorized Official Telephone Number:
760-323-2118

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)





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