1982708087 NPI number — BEATE LOUISE GISELA CARRIERE PT CI FU

Table of content: BEATE LOUISE GISELA CARRIERE PT CI FU (NPI 1982708087)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982708087 NPI number — BEATE LOUISE GISELA CARRIERE PT CI FU

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARRIERE
Provider First Name:
BEATE
Provider Middle Name:
LOUISE GISELA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT CI FU
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:
1982708087
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:
7080 HOLLYWOOD BLVD
Provider Second Line Business Mailing Address:
#815
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90028-6906
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-957-9571
Provider Business Mailing Address Fax Number:
323-957-9583

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7080 HOLLYWOOD BLVD
Provider Second Line Business Practice Location Address:
#815
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-957-9571
Provider Business Practice Location Address Fax Number:
323-957-9583
Provider Enumeration Date:
09/11/2006

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: 225100000X , with the licence number:  PT7201 , 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)