1295145134 NPI number — PERIOPERATIVE CARE CONSULTANTS INC

Table of content: (NPI 1295145134)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295145134 NPI number — PERIOPERATIVE CARE CONSULTANTS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PERIOPERATIVE CARE CONSULTANTS 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:
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:
1295145134
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/30/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7001
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TARZANA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91357-7001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-888-7815
Provider Business Mailing Address Fax Number:
818-715-1722

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6815 NOBLE AVE
Provider Second Line Business Practice Location Address:
STE.#400
Provider Business Practice Location Address City Name:
VAN NUYS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91405-3796
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-888-7815
Provider Business Practice Location Address Fax Number:
818-715-1722
Provider Enumeration Date:
04/30/2014

Additional Information

Authorized Official

Authorized Official Last Name:
ATOIAN
Authorized Official First Name:
ANDRE
Authorized Official Middle Name:
G
Authorized Official Title or Position:
PRESIDENT/ SOLE OWNER
Authorized Official Telephone Number:
310-951-8400

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  A107342 , 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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