1700026358 NPI number — CHRISTINE A. HEARD, D.P.M..

Table of content: (NPI 1700026358)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700026358 NPI number — CHRISTINE A. HEARD, D.P.M..

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHRISTINE A. HEARD, D.P.M..
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:
1700026358
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/23/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2100 CARLMONT DR
Provider Second Line Business Mailing Address:
SUITE 4
Provider Business Mailing Address City Name:
BELMONT
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94002-3482
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
650-591-6436
Provider Business Mailing Address Fax Number:
650-591-6456

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2100 CARLMONT DR
Provider Second Line Business Practice Location Address:
SUITE 4
Provider Business Practice Location Address City Name:
BELMONT
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94002-3482
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-591-6436
Provider Business Practice Location Address Fax Number:
650-591-6456
Provider Enumeration Date:
02/23/2009

Additional Information

Authorized Official

Authorized Official Last Name:
HEARD
Authorized Official First Name:
CHRISTINE
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
650-591-6436

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  E3535 , 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: 000E35351 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com