1073237830 NPI number — MALUHIA THERAPY SERVICES LLC

Table of content: (NPI 1073237830)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073237830 NPI number — MALUHIA THERAPY SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MALUHIA THERAPY SERVICES LLC
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:
1073237830
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/19/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7308 FEATHER RIVER DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAKERSFIELD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93308-6450
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4646 WILSON RD STE 101A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-5895
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-368-5065
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/26/2022

Additional Information

Authorized Official

Authorized Official Last Name:
HILL
Authorized Official First Name:
SAMANTHA
Authorized Official Middle Name:
FLORA
Authorized Official Title or Position:
PRESIDENT, CLINICIAN
Authorized Official Telephone Number:
661-368-5065

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1487281549 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1508232000 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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