1952503351 NPI number — MISS AMANDA RENE' FRANK A.T.C.

Table of content: MISS AMANDA RENE' FRANK A.T.C. (NPI 1952503351)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952503351 NPI number — MISS AMANDA RENE' FRANK A.T.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRANK
Provider First Name:
AMANDA
Provider Middle Name:
RENE'
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
A.T.C.
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:
1952503351
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:
16114 CHALLIS ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FOUNTAIN VALLEY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92708-1431
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-477-2322
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5772 BOLSA AVE
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
HUNTINGTON BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92649-1134
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-897-3589
Provider Business Practice Location Address Fax Number:
714-897-1316
Provider Enumeration Date:
06/05/2007

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: 2255A2300X , 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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