1518998723 NPI number — DRS. MISHAL, PHAM & ASSOCIATES

Table of content: (NPI 1518998723)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518998723 NPI number — DRS. MISHAL, PHAM & ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DRS. MISHAL, PHAM & ASSOCIATES
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:
1518998723
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/16/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8500 FLORENCE AVE
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
DOWNEY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90240-4054
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-869-4579
Provider Business Mailing Address Fax Number:
562-862-1765

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8500 FLORENCE AVE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
DOWNEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90240-4054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-869-4579
Provider Business Practice Location Address Fax Number:
562-862-1765
Provider Enumeration Date:
07/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MISHAL
Authorized Official First Name:
DEVADATT
Authorized Official Middle Name:
MADHUKAR
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
562-869-4579

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  A36594 , 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: GR0082351 . This is a "GROUP MEDICAL RENDERING NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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