1790722791 NPI number — GUOPING CAI

Table of content: GUOPING CAI (NPI 1790722791)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790722791 NPI number — GUOPING CAI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CAI
Provider First Name:
GUOPING
Provider Middle Name:
Provider Name Prefix Text:
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:
1790722791
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/28/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5912 BOLSA AVE
Provider Second Line Business Mailing Address:
STE 201
Provider Business Mailing Address City Name:
HUNTINGTON BEACH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92649-1146
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-898-5732
Provider Business Mailing Address Fax Number:
714-901-4058

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
416 W LAS TUNAS DR
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
SAN GABRIEL
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91776-1236
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-281-9889
Provider Business Practice Location Address Fax Number:
262-281-0339
Provider Enumeration Date:
05/31/2006

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: 237700000X , with the licence number:  HA4171 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237600000X , with the licence number: AU2137 , 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)

  • Identifier: 416 W LAS TUNAS DR , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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