1952346298 NPI number — TERRAPIN TECHNOLOGIES, INC

Table of content: (NPI 1952346298)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952346298 NPI number — TERRAPIN TECHNOLOGIES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TERRAPIN TECHNOLOGIES, 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:
TERRAPIN ORTHOPEDICS
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:
1952346298
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/19/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1508 CABRILLO AVE
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
TORRANCE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90501-2801
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-212-3067
Provider Business Mailing Address Fax Number:
888-776-9566

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1508 CABRILLO AVE
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
TORRANCE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90501-2801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-212-3067
Provider Business Practice Location Address Fax Number:
888-776-9566
Provider Enumeration Date:
06/19/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BAINER
Authorized Official First Name:
DALILA
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
310-212-3067

Provider Taxonomy Codes

  • Taxonomy code: 224P00000X , with the licence number:  CP002624 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X , with the licence number: 100632 , 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: ZZZ62594Z . This is a "BLUE CROSS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".