1144391996 NPI number — MR. ABDOLRHIM MOHAMAD AMINZADEH ACUPUNCTURIST

Table of content: MR. ABDOLRHIM MOHAMAD AMINZADEH ACUPUNCTURIST (NPI 1144391996)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144391996 NPI number — MR. ABDOLRHIM MOHAMAD AMINZADEH ACUPUNCTURIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AMINZADEH
Provider First Name:
ABDOLRHIM
Provider Middle Name:
MOHAMAD
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
ACUPUNCTURIST
Provider Gender Code:
M

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:
1144391996
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:
6 W BAR LE DOC DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORPUS CHRISTI
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78414-6248
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
361-992-2048
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6500 S PADRE ISLAND DR STE 18
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORPUS CHRISTI
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78412-4055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-992-2048
Provider Business Practice Location Address Fax Number:
361-992-2094
Provider Enumeration Date:
11/13/2006

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: 171100000X , with the licence number:  AC00183 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: AC00183 . This is a "LICENSE NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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