1245354372 NPI number — INSIGHT HEALTH CORP

Table of content: DR. JENNIFER LAUREN BAIRD PHARMD (NPI 1760205678)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245354372 NPI number — INSIGHT HEALTH CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INSIGHT HEALTH CORP
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:
1245354372
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26250 ENTERPRISE CT
Provider Second Line Business Mailing Address:
STE 100
Provider Business Mailing Address City Name:
LAKE FOREST
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92630
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-282-6000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 NORTH GREEN VALLEY PKWY
Provider Second Line Business Practice Location Address:
STE 130
Provider Business Practice Location Address City Name:
HENDERSON
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-990-7419
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/16/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DRAZBA
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
G
Authorized Official Title or Position:
SENIOR VP, CHIEF ACCOUNTING OFFICER
Authorized Official Telephone Number:
949-282-6000

Provider Taxonomy Codes

  • Taxonomy code: 293D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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