NPI Code Detail JSON Logo

1306573480 NPI number — ZANDRI TERLEP PA-C

NPI Number: 1306573480
Health Care Provider/Practitioner: ZANDRI TERLEP PA-C

Information about “1306573480” NPI (ZANDRI TERLEP PA-C) exists in 1306573480 in HTML format HTML  |  1306573480 in plain Text format TXT  |  1306573480 in PDF (Portable Document Format) PDF  |  1306573480 in an XML format XML  formats.

NPI Number : 1306573480 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1306573480",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "TERLEP",
    "FirstName": "ZANDRI",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PA-C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 1034",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "POMONA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "91769-1034",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "13193 CENTRAL AVE STE 220",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CHINO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "91710-4179",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "909-591-0843",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/08/2022",
    "LastUpdateDate": "08/08/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "363AM0700X",
          "TaxonomyName": "Medical Physician Assistant",
          "LicenseNumber": "61293",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": "61293",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.