1558513044 NPI number — MOMENTUM AGENCIES

Table of content: (NPI 1558513044)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558513044 NPI number — MOMENTUM AGENCIES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOMENTUM AGENCIES
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:
UCP/SCF NEWPORT
Provider Other Organization Name Type Code:
5
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:
1558513044
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/29/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6430 INDEPENDENCE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WOODLAND HILLS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91367-2607
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-782-2211
Provider Business Mailing Address Fax Number:
818-909-9106

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11051 OLD SANTA SUSANA PASS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHATSWORTH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91311-1206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-998-8755
Provider Business Practice Location Address Fax Number:
818-998-7796
Provider Enumeration Date:
10/16/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MAROTTA
Authorized Official First Name:
KIMBERLY
Authorized Official Middle Name:
Authorized Official Title or Position:
ACCOUNTS RECEIVABLE MANAGER
Authorized Official Telephone Number:
818-782-2211

Provider Taxonomy Codes

  • Taxonomy code: 320600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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