1386708816 NPI number — APPLIED CLINICAL RESEARCH

Table of content: (NPI 1386708816)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386708816 NPI number — APPLIED CLINICAL RESEARCH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
APPLIED CLINICAL RESEARCH
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:
1386708816
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6565 NANCY RIDGE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN DIEGO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92121-2251
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
858-677-7970
Provider Business Mailing Address Fax Number:
858-677-7998

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6565 NANCY RIDGE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-677-7970
Provider Business Practice Location Address Fax Number:
858-677-7998
Provider Enumeration Date:
12/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GRAAS
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PRESIDENT - CEO
Authorized Official Telephone Number:
858-677-7970

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  CLF 4838 , 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: 32942000 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7001273 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: LAB42965G , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com