1578648507 NPI number — D & B HEALTH CARE PROFESSIONALS BURBANK, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578648507 NPI number — D & B HEALTH CARE PROFESSIONALS BURBANK, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
D & B HEALTH CARE PROFESSIONALS BURBANK, 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:
6
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:
1578648507
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/19/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12140 ARTESIA BLVD
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
ARTESIA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90701-4058
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-848-8887
Provider Business Mailing Address Fax Number:
562-924-1878

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12140 ARTESIA BLVD
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
ARTESIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90701-4058
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-848-8887
Provider Business Practice Location Address Fax Number:
562-924-1878
Provider Enumeration Date:
10/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
COLCOL
Authorized Official First Name:
PRIMO
Authorized Official Middle Name:
MAGLAYA
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
818-848-8887

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of NULL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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