1447595434 NPI number — DR. ALLISON CHICO NELSON P.T., D.P.T.

Table of content: DR. ALLISON CHICO NELSON P.T., D.P.T. (NPI 1447595434)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447595434 NPI number — DR. ALLISON CHICO NELSON P.T., D.P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NELSON
Provider First Name:
ALLISON
Provider Middle Name:
CHICO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
P.T., D.P.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHICO
Provider Other First Name:
ALLISON
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
P.T., D.P.T
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1447595434
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/13/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5850 EL CAMINO REAL
Provider Second Line Business Mailing Address:
100
Provider Business Mailing Address City Name:
CARLSBAD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92008-8816
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-804-1700
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5850 EL CAMINO REAL
Provider Second Line Business Practice Location Address:
100
Provider Business Practice Location Address City Name:
CARLSBAD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92008-8816
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-804-1700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/03/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  38762 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2251X0800X , with the licence number: 38762 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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