1255060455 NPI number — TPIRC MEDICAL FOUNDATION INC

Table of content: (NPI 1255060455)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255060455 NPI number — TPIRC MEDICAL FOUNDATION INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TPIRC MEDICAL FOUNDATION INC
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:
TRANSLATIONAL PULMONARY AND IMMUNOLOGY RESEARCH
Provider Other Organization Name Type Code:
5
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:
1255060455
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/12/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2246
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEAL BEACH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90740-1246
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-490-9900
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2067 W VISTA WAY STE 250
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VISTA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92083-6034
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-490-9900
Provider Business Practice Location Address Fax Number:
562-317-1387
Provider Enumeration Date:
06/06/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LOHARA
Authorized Official First Name:
ANOOP
Authorized Official Middle Name:
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
805-504-6217

Provider Taxonomy Codes

  • Taxonomy code: 2080P0201X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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