1144685215 NPI number — DR. HENRY JOHN ORFF PH.D.

Table of content: DR. HENRY JOHN ORFF PH.D. (NPI 1144685215)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144685215 NPI number — DR. HENRY JOHN ORFF PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ORFF
Provider First Name:
HENRY
Provider Middle Name:
JOHN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
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:
1144685215
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/30/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 232410
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN DIEGO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92193-2410
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
858-249-6748
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3350 LA JOLLA VILLAGE DRIVE
Provider Second Line Business Practice Location Address:
VA SAN DIEGO HEALTHCARE SYSTEM
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92161
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-642-6492
Provider Business Practice Location Address Fax Number:
858-642-6430
Provider Enumeration Date:
12/16/2015

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: 103TC0700X , with the licence number:  PSY27099 , 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)





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