1366699852 NPI number — MOUNTAIN RIGHT TO LIFE

Table of content: MS. CHERYL ANN SUING L.AC. (NPI 1639306152)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366699852 NPI number — MOUNTAIN RIGHT TO LIFE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOUNTAIN RIGHT TO LIFE
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:
1366699852
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/26/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
114 E AIRPORT DR STE 104
Provider Second Line Business Mailing Address:
P.O. BOX 11225, SAN BERNARDINO, CA 92423
Provider Business Mailing Address City Name:
SAN BERNARDINO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92408-3420
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-382-4550
Provider Business Mailing Address Fax Number:
909-382-4551

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
114 E AIRPORT DR STE 104
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN BERNARDINO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92408-3420
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-382-4550
Provider Business Practice Location Address Fax Number:
909-382-4551
Provider Enumeration Date:
08/26/2008

Additional Information

Authorized Official

Authorized Official Last Name:
STIEFKEN
Authorized Official First Name:
LISA
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
909-382-4550

Provider Taxonomy Codes

  • Taxonomy code: 251V00000X , with the licence number:  240000750 , 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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