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1073093472 NPI number — PIVOT ACUPUNCTURE & INTEGRATIVE HEALTH INC

NPI Number: 1073093472
Health Care Provider/Practitioner: PIVOT ACUPUNCTURE & INTEGRATIVE HEALTH INC

Information about “1073093472” NPI (PIVOT ACUPUNCTURE & INTEGRATIVE HEALTH INC) exists in 1073093472 in HTML format HTML  |  1073093472 in plain Text format TXT  |  1073093472 in PDF (Portable Document Format) PDF  |  1073093472 in an XML format XML  formats.

NPI Number : 1073093472 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1073093472",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PIVOT ACUPUNCTURE & INTEGRATIVE HEALTH INC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "480 REDWOOD ST STE 14",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "VALLEJO",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "94590-2958",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "707-653-0495",
    "MailingAddressFaxNumber": "707-638-0384",
    "FirstLinePracticeLocationAddress": "480 REDWOOD ST STE 14",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "VALLEJO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "94590-2958",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "707-653-0495",
    "PracticeLocationAddressFaxNumber": "707-638-0384",
    "EnumerationDate": "08/16/2018",
    "LastUpdateDate": "08/16/2018",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "LOPES",
    "AuthorizedOfficialFirstName": "SHAWNE",
    "AuthorizedOfficialMiddleName": "J",
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LAC",
    "AuthorizedOfficialTelephoneNumber": "707-653-0495",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "171100000X",
        "TaxonomyName": "Acupuncturist",
        "LicenseNumber": "AC16814",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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