1316269780 NPI number — CRASH, INC.

Table of content: (NPI 1316269780)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316269780 NPI number — CRASH, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CRASH, 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:
1316269780
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/13/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1081 CAMINO DEL RIO S
Provider Second Line Business Mailing Address:
SUITE 129
Provider Business Mailing Address City Name:
SAN DIEGO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92108-3542
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
619-297-5131
Provider Business Mailing Address Fax Number:
619-296-3846

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
220 EUCLID AVE
Provider Second Line Business Practice Location Address:
SUITE 120
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92114-3644
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-263-6663
Provider Business Practice Location Address Fax Number:
619-263-0655
Provider Enumeration Date:
02/25/2010

Additional Information

Authorized Official

Authorized Official Last Name:
HIMMELBERGER
Authorized Official First Name:
MARY
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
619-297-5131

Provider Taxonomy Codes

  • Taxonomy code: 261QR0405X , with the licence number:  370024NN , 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)

  • Identifier: 8755 . This is a "STATE OF CALIFORNIA DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com