1780352526 NPI number — MR. GEORGE MUNYAGA NYAMU

Table of content: MR. GEORGE MUNYAGA NYAMU (NPI 1780352526)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780352526 NPI number — MR. GEORGE MUNYAGA NYAMU

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NYAMU
Provider First Name:
GEORGE
Provider Middle Name:
MUNYAGA
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

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:
1780352526
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/15/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 86537
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85754-6537
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-721-1887
Provider Business Mailing Address Fax Number:
520-372-7126

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2828 W GOLDFIELD DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85745-3502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-306-3632
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/04/2021

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: 3104A0625X , with the licence number:  AL11941H , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171W00000X , with the licence number: BH8372 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: D42205954 . This is a "DRIVERS LICENSE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com