1710287339 NPI number — PACIFIC GROVE HYPERBARIC CHAMBER

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 1710287339 NPI number — PACIFIC GROVE HYPERBARIC CHAMBER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PACIFIC GROVE HYPERBARIC CHAMBER
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:
1710287339
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/29/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 FOREST AVENUE
Provider Second Line Business Mailing Address:
ATTN: CATHY KRYSYNA
Provider Business Mailing Address City Name:
PACIFIC GROVE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93950
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
831-648-3102
Provider Business Mailing Address Fax Number:
831-375-9863

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 PINE AVE
Provider Second Line Business Practice Location Address:
ATTN: HYPERBARIC CHAMBER
Provider Business Practice Location Address City Name:
PACIFIC GROVE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93950-3317
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
831-236-6094
Provider Business Practice Location Address Fax Number:
831-648-3107
Provider Enumeration Date:
10/29/2010

Additional Information

Authorized Official

Authorized Official Last Name:
BECKLENBERG
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
LUKE
Authorized Official Title or Position:
DEPUTY CITY MANAGER
Authorized Official Telephone Number:
831-648-3170

Provider Taxonomy Codes

  • Taxonomy code: 251V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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