1508997438 NPI number — PHILLIP HARRY VAN WHY 24720000X

Table of content: PHILLIP HARRY VAN WHY 24720000X (NPI 1508997438)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508997438 NPI number — PHILLIP HARRY VAN WHY 24720000X

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VAN WHY
Provider First Name:
PHILLIP
Provider Middle Name:
HARRY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
24720000X
Provider Gender Code:
M

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:
1508997438
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
608 AKRON STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOUNTAIN VIEW
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94043
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
650-386-6613
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
USCG AIR STATION SAN FRANCISCO
Provider Second Line Business Practice Location Address:
SFO INTL. AIRPORT, BLDG 1020
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94128-3099
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-808-2937
Provider Business Practice Location Address Fax Number:
650-808-2916
Provider Enumeration Date:
03/09/2007

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: 247200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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