1952491029 NPI number — MS. MARGARET LOUISE GOOD FNP

Table of content: DR. SAVITA D DATTA MD (NPI 1093808768)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952491029 NPI number — MS. MARGARET LOUISE GOOD FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOOD
Provider First Name:
MARGARET
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

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:
1952491029
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1425 LYONS AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TURLOCK
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95380-4123
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
209-632-6912
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 W COOLIDGE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MODESTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95350-4447
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-579-2300
Provider Business Practice Location Address Fax Number:
209-579-1948
Provider Enumeration Date:
10/12/2006

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: 363LF0000X , with the licence number:  RN604735 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 363LX0001X , with the licence number: RN604735 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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