1598910549 NPI number — ARCADIAN HEALTH PLAN, INC.

Table of content: (NPI 1598910549)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598910549 NPI number — ARCADIAN HEALTH PLAN, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARCADIAN HEALTH PLAN, 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:
1598910549
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/01/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 12TH ST STE 350
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAKLAND
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94607-5204
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-832-0311
Provider Business Mailing Address Fax Number:
510-817-1894

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 12TH ST STE 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94607-4087
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-832-0311
Provider Business Practice Location Address Fax Number:
510-817-1894
Provider Enumeration Date:
11/18/2008

Additional Information

Authorized Official

Authorized Official Last Name:
NOVELLO
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
Authorized Official Title or Position:
SR. VP AND GENERAL COUNSEL
Authorized Official Telephone Number:
510-817-1845

Provider Taxonomy Codes

  • Taxonomy code: 302R00000X , with the licence number:  12151 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 302R00000X , with the licence number: 112421 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 302R00000X , with the licence number: 166975 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 302R00000X , with the licence number: 13794 (FOR AHP) , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 302R00000X , with the licence number: 174 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 302R00000X , with the licence number: FILE NUMBER 933 0468 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 302R00000X , with the licence number: 12151 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 302R00000X , with the licence number: 103078 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 302R00000X , with the licence number: 12151 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 103078 . This is a "MEDICARE ADVANTAGE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 166975 . This is a "MEDICARE ADVANTAGE" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: FILE NUMBER 933 0468 . This is a "MEDICARE ADVANTAGE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 12151 . This is a "MEDICARE ADVANTAGE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 12151 . This is a "MEDICARE ADVANTAGE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 12151 . This is a "MEDICARE ADVANTAGE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 13794 (FOR AHP) . This is a "MEDICARE ADVANTAGE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 112421 . This is a "MEDICARE ADVANTAGE" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 174 . This is a "MEDICARE ADVANTAGE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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