1750531893 NPI number — DR. KATHERINE QUINLAN MOORE PH.D.

Table of content: DR. KATHERINE QUINLAN MOORE PH.D. (NPI 1750531893)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750531893 NPI number — DR. KATHERINE QUINLAN MOORE PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOORE
Provider First Name:
KATHERINE
Provider Middle Name:
QUINLAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
QUINLAN
Provider Other First Name:
KATHERINE
Provider Other Middle Name:
MARY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1750531893
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
892 27TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN DIEGO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92154-1444
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
619-575-4687
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
892 27TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92154-1444
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-575-4687
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/25/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com