1063947539 NPI number — CHEST AND CRITICAL CARE CONSULTANTS, A MEDICAL GROUP

Table of content: (NPI 1063947539)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063947539 NPI number — CHEST AND CRITICAL CARE CONSULTANTS, A MEDICAL GROUP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHEST AND CRITICAL CARE CONSULTANTS, A MEDICAL GROUP
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:
FAMILY HEALTH CENTER OF PLACENTIA
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:
1063947539
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/21/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 15090
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANAHEIM
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92803-5090
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-232-2301
Provider Business Mailing Address Fax Number:
714-202-2320

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1041 E YORBA LINDA BLVD
Provider Second Line Business Practice Location Address:
SUITE 306
Provider Business Practice Location Address City Name:
PLACENTIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92870-3728
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-577-9500
Provider Business Practice Location Address Fax Number:
714-577-9504
Provider Enumeration Date:
04/21/2017

Additional Information

Authorized Official

Authorized Official Last Name:
GOGIA
Authorized Official First Name:
HARMOHINDER
Authorized Official Middle Name:
Authorized Official Title or Position:
SENIOR MANAGING PARTNER
Authorized Official Telephone Number:
714-577-2124

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





Copyright © 2007-2024 www.npivalidator.com