1871872697 NPI number — MEDWIN HOSPITALIST AND HEALTHCARE NETWORK

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871872697 NPI number — MEDWIN HOSPITALIST AND HEALTHCARE NETWORK

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEDWIN HOSPITALIST AND HEALTHCARE NETWORK
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1871872697
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/10/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
910 SOUTH SUNSET AVE. SUITE# 7 AND 8
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91790
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-338-1155
Provider Business Mailing Address Fax Number:
626-338-1125

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
910 S SUNSET AVE STE 7AND8
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST COVINA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91790-3409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-338-1155
Provider Business Practice Location Address Fax Number:
626-338-1125
Provider Enumeration Date:
08/10/2011

Additional Information

Authorized Official

Authorized Official Last Name:
TULPULE
Authorized Official First Name:
RADHIKA
Authorized Official Middle Name:
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
626-338-1155

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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