1992911507 NPI number — DR. WILLIAM GARVEY WILLIAM GARVEY PHD

Table of content: DR. WILLIAM GARVEY WILLIAM GARVEY PHD (NPI 1992911507)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992911507 NPI number — DR. WILLIAM GARVEY WILLIAM GARVEY PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARVEY
Provider First Name:
WILLIAM
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
WILLIAM GARVEY PHD
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:
1992911507
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:
18809 COX AVE
Provider Second Line Business Mailing Address:
STE 290
Provider Business Mailing Address City Name:
SARATOGA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95066-4185
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-379-8270
Provider Business Mailing Address Fax Number:
831-438-7886

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18809 COX AVE
Provider Second Line Business Practice Location Address:
STE 290
Provider Business Practice Location Address City Name:
SARATOGA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95066-4185
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-379-8270
Provider Business Practice Location Address Fax Number:
831-438-7886
Provider Enumeration Date:
05/14/2007

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: 103TC1900X , with the licence number:  PSY3293 , 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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