1255412078 NPI number — PARIS E. ROYO MD INC

Table of content: (NPI 1255412078)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255412078 NPI number — PARIS E. ROYO MD INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PARIS E. ROYO MD 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:
Provider Other Organization Name Type Code:
6
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:
1255412078
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/07/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
320 H ST
Provider Second Line Business Mailing Address:
STE 4
Provider Business Mailing Address City Name:
MARYSVILLE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95901
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
530-743-1873
Provider Business Mailing Address Fax Number:
530-743-0427

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1524 EUREKA RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROSEVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95661-3040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-783-7696
Provider Business Practice Location Address Fax Number:
916-783-4199
Provider Enumeration Date:
10/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ROYO
Authorized Official First Name:
PARIS
Authorized Official Middle Name:
E
Authorized Official Title or Position:
MEDICAL DIRECTOR / CEO
Authorized Official Telephone Number:
916-783-7696

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com