1548622376 NPI number — PEOPLE'S CARE NEVADA INC

Table of content: (NPI 1548622376)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548622376 NPI number — PEOPLE'S CARE NEVADA INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PEOPLE'S CARE NEVADA INC
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:
1548622376
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/22/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13920 CITY CENTER DR
Provider Second Line Business Mailing Address:
SUITE 290
Provider Business Mailing Address City Name:
CHINO HILLS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91709-5432
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-287-3557
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7312 W CHEYENNE AVE
Provider Second Line Business Practice Location Address:
STE 2
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89129-7428
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-960-0018
Provider Business Practice Location Address Fax Number:
702-522-6077
Provider Enumeration Date:
03/22/2016

Additional Information

Authorized Official

Authorized Official Last Name:
KAISER
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT / CEO
Authorized Official Telephone Number:
909-287-3557

Provider Taxonomy Codes

  • Taxonomy code: 385H00000X , with the licence number:  G62-09975 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 9005058811 . This is a "API" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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