1740512748 NPI number — ABUNDANT HEALTHCARE CORPORATION

Table of content: JOSEPH GREGORY DOLAN MD (NPI 1447592605)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740512748 NPI number — ABUNDANT HEALTHCARE CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ABUNDANT HEALTHCARE CORPORATION
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:
1740512748
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/02/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
941 E VALLEY PKWY
Provider Second Line Business Mailing Address:
#100
Provider Business Mailing Address City Name:
ESCONDIDO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92025-3433
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-746-2331
Provider Business Mailing Address Fax Number:
760-746-9729

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
941 E VALLEY PKWY
Provider Second Line Business Practice Location Address:
#100
Provider Business Practice Location Address City Name:
ESCONDIDO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92025-3433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-746-2331
Provider Business Practice Location Address Fax Number:
760-746-9729
Provider Enumeration Date:
02/02/2010

Additional Information

Authorized Official

Authorized Official Last Name:
BERNOU
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
ANDREW
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
760-746-2331

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332BX2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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