1508189358 NPI number — MS. CATALINA KORNBLUEH PEREZ RDHAP, RDH

Table of content: MS. CATALINA KORNBLUEH PEREZ RDHAP, RDH (NPI 1508189358)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508189358 NPI number — MS. CATALINA KORNBLUEH PEREZ RDHAP, RDH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KORNBLUEH PEREZ
Provider First Name:
CATALINA
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RDHAP, RDH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BLANCO PEREZ
Provider Other First Name:
CATALINA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RDHAP, RDH
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1508189358
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/09/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 S MURPHY AVE STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUNNYVALE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94086-6118
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
650-861-1965
Provider Business Mailing Address Fax Number:
650-434-0418

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 S MURPHY AVE STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUNNYVALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94086-6118
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-861-1965
Provider Business Practice Location Address Fax Number:
650-434-0418
Provider Enumeration Date:
03/09/2010

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: 124Q00000X , with the licence number:  HAP 264 , 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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