1689828105 NPI number — CARMELITA UY MD INC

Table of content: (NPI 1689828105)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689828105 NPI number — CARMELITA UY MD INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARMELITA UY MD 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:
1689828105
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/18/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2340 EAST 8TH STREET
Provider Second Line Business Mailing Address:
SUITE-E
Provider Business Mailing Address City Name:
NATIONAL CITY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91950-2870
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
619-216-8500
Provider Business Mailing Address Fax Number:
619-216-8511

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2340 EAST 8TH STREET
Provider Second Line Business Practice Location Address:
SUITE-E
Provider Business Practice Location Address City Name:
NATIONAL CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91950-2870
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-216-8500
Provider Business Practice Location Address Fax Number:
619-216-8511
Provider Enumeration Date:
11/11/2008

Additional Information

Authorized Official

Authorized Official Last Name:
UY
Authorized Official First Name:
CARMELITA
Authorized Official Middle Name:
LUNA
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
619-216-8500

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  C50548 , 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)

  • Identifier: 00C505480 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3957538 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com