1003492323 NPI number — JB ARTHRITIS AND RHEUMATOLOGY CENTER

Table of content: (NPI 1003492323)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003492323 NPI number — JB ARTHRITIS AND RHEUMATOLOGY CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JB ARTHRITIS AND RHEUMATOLOGY 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:
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:
1003492323
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/25/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11480 BROOKSHIRE AVE STE 108
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DOWNEY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90241-5020
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-459-4000
Provider Business Mailing Address Fax Number:
562-459-4001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11480 BROOKSHIRE AVE STE 108
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOWNEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90241-5020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-459-4000
Provider Business Practice Location Address Fax Number:
562-459-4001
Provider Enumeration Date:
03/18/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BUCHFUHRER
Authorized Official First Name:
JULIA
Authorized Official Middle Name:
ELLEN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
562-459-4000

Provider Taxonomy Codes

  • Taxonomy code: 207RR0500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QH0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QI0500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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