1982637948 NPI number — DR. PAUL ZAMORA SEVILLE M.D.

Table of content: DR. PAUL ZAMORA SEVILLE M.D. (NPI 1982637948)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982637948 NPI number — DR. PAUL ZAMORA SEVILLE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SEVILLE
Provider First Name:
PAUL
Provider Middle Name:
ZAMORA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1982637948
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/15/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6401 KIMBALL DRIVE, NW
Provider Second Line Business Mailing Address:
STE 202
Provider Business Mailing Address City Name:
GIG HARBOR
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98335
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-858-9192
Provider Business Mailing Address Fax Number:
253-858-4330

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6401 KIMBALL DRIVE, NW
Provider Second Line Business Practice Location Address:
STE 202
Provider Business Practice Location Address City Name:
GIG HARBOR
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98335
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-858-9192
Provider Business Practice Location Address Fax Number:
253-858-4330
Provider Enumeration Date:
07/09/2006

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: 174400000X , with the licence number:  A78182 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208800000X , with the licence number: MD00048744 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00A78120 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8945364 . This is a "STATE CRIME VICTIMS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: P00467951 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 8945364 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0225685 . This is a "STATE L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 0224050 . This is a "STATE L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 0224051 . This is a "STATE L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 0224716 . This is a "STATE L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 0226773 . This is a "STATE L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com