1457545840 NPI number — HEMATOLOGY/ONCOLOGY CONSULTANTS

Table of content: MRS. TIFFANEY ANNE TWO EAGLE RN (NPI 1235650250)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457545840 NPI number — HEMATOLOGY/ONCOLOGY CONSULTANTS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEMATOLOGY/ONCOLOGY CONSULTANTS
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:
1457545840
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/29/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 N SAN JACINTO ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HEMET
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92543-3119
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
951-766-6460
Provider Business Mailing Address Fax Number:
951-791-4101

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
36450 INLAND VALLEY DR
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
WILDOMAR
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92595-9583
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-696-0498
Provider Business Practice Location Address Fax Number:
951-461-7324
Provider Enumeration Date:
08/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SCHINKE
Authorized Official First Name:
STANLEY
Authorized Official Middle Name:
D
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
951-766-6460

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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