1528224706 NPI number — DR. EDWARD P VAHEY D.M.D., M.S.

Table of content: DR. EDWARD P VAHEY D.M.D., M.S. (NPI 1528224706)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528224706 NPI number — DR. EDWARD P VAHEY D.M.D., M.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VAHEY
Provider First Name:
EDWARD
Provider Middle Name:
P
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.M.D., M.S.
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:
1528224706
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/06/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
347 B GELLERT BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALY CITY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94015
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
650-757-5700
Provider Business Mailing Address Fax Number:
650-757-5707

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
347 B GELLERT BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALY CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94015
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-757-5700
Provider Business Practice Location Address Fax Number:
650-757-5707
Provider Enumeration Date:
08/06/2008

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: 1223P0300X , with the licence number:  39101 , 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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