1023073673 NPI number — EVERYTHING MEDICAL INC

Table of content: (NPI 1023073673)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023073673 NPI number — EVERYTHING MEDICAL INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EVERYTHING MEDICAL 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:
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:
1023073673
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/23/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 S PALM AVE
Provider Second Line Business Mailing Address:
UNIT A
Provider Business Mailing Address City Name:
ALHAMBRA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91801-3132
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-284-2500
Provider Business Mailing Address Fax Number:
626-284-2555

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 S PALM AVE
Provider Second Line Business Practice Location Address:
UNIT A
Provider Business Practice Location Address City Name:
ALHAMBRA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91801-3132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-284-2500
Provider Business Practice Location Address Fax Number:
626-284-2555
Provider Enumeration Date:
04/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KEITH
Authorized Official First Name:
JONATHAN
Authorized Official Middle Name:
G
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
626-284-2500

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X , with the licence number:  43730 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BC3200X , with the licence number: 43730 , 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: 345862 . This is a "SECURE HORIZONS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: DME03044G , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4264490001 . This is a "PEOPLES BENIFIT LIFE IN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: PD1555 . This is a "LANTERMAN REGIONAL CENTER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 253080 . This is a "MDA ASSOC" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: MS0059 . This is a "ALTA MED HEALTH SERVICES" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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