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1164553053 NPI number — SYCUAN TRIBAL GOVERNMENT

NPI Number: 1164553053
Health Care Provider/Practitioner: SYCUAN TRIBAL GOVERNMENT

Information about “1164553053” NPI (SYCUAN TRIBAL GOVERNMENT) exists in 1164553053 in HTML format HTML  |  1164553053 in plain Text format TXT  |  1164553053 in PDF (Portable Document Format) PDF  |  1164553053 in an XML format XML  formats.

NPI Number : 1164553053 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1164553053",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "SYCUAN TRIBAL GOVERNMENT",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5442 DEHESA RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "EL CAJON",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92019-1816",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "619-445-3518",
    "MailingAddressFaxNumber": "619-445-5814",
    "FirstLinePracticeLocationAddress": "5442 DEHESA RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "EL CAJON",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92019-1816",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "619-445-3518",
    "PracticeLocationAddressFaxNumber": "619-445-5814",
    "EnumerationDate": "03/09/2007",
    "LastUpdateDate": "04/06/2017",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "FALCO",
    "AuthorizedOfficialFirstName": "SAL",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CONTROLLER AND CEO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "BS",
    "AuthorizedOfficialTelephoneNumber": "619-445-0707",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "333600000X",
          "TaxonomyName": "Pharmacy",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "332800000X",
          "TaxonomyName": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "3336C0003X",
          "TaxonomyName": "Community/Retail Pharmacy",
          "LicenseNumber": "PHE39873",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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