1750895405 NPI number — MS. NORA G FERGUSON DO CNA

Table of content: MS. NORA G FERGUSON DO CNA (NPI 1750895405)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750895405 NPI number — MS. NORA G FERGUSON DO CNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FERGUSON
Provider First Name:
NORA
Provider Middle Name:
G
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
DO CNA
Provider Gender Code:
F

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:
1750895405
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/16/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12245 MANOR DR APT C
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAWTHORNE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90250-3751
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-247-6065
Provider Business Mailing Address Fax Number:
424-269-1452

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12245 MANOR DR APT C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAWTHORNE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90250-3751
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-247-6065
Provider Business Practice Location Address Fax Number:
424-269-1452
Provider Enumeration Date:
11/16/2017

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: 146D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 814937838 . This is a "MEDICARE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 814937838 . This is a "SCAN INS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 814937838 . This is a "HEALTH NET" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 814937838 . This is a "CAREFIRST" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 814937838 . This is a "CIGNA HEALTH GROUP" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 814937838 . This is a "KAISER FOUNDATION GROUP" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 814937838 . This is a "MEDI-CAL" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 814937838 . This is a "AETNA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 814937838 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 814937838 . This is a "HMO INSURANCE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 814937838 . This is a "BLUE SHIELD OF CALIFORNIA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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