1760542252 NPI number — MS. LAUREL JEAN BABCOCK GILL NP

Table of content: MS. LAUREL JEAN BABCOCK GILL NP (NPI 1760542252)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760542252 NPI number — MS. LAUREL JEAN BABCOCK GILL NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BABCOCK GILL
Provider First Name:
LAUREL
Provider Middle Name:
JEAN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BABCOCK
Provider Other First Name:
LAUREL
Provider Other Middle Name:
JEAN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN NP
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1760542252
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5651 MARSHALL DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGTON BEACH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92649-2723
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-846-5183
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1250 BELLFLOWER BLVD
Provider Second Line Business Practice Location Address:
SHS
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90840-0201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-985-5146
Provider Business Practice Location Address Fax Number:
562-985-8404
Provider Enumeration Date:
12/12/2006

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: 363L00000X , with the licence number:  RN372597 , 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)





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