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General NPI Number Information
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NPI Number | 1316698525
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Entity Type | Organization
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Legal Business Name | CONGREGATION PIRCHEI SHOSHANIM
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Dates
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Enumeration Date | 01/10/2022
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Last Update Date | 01/10/2022
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Provider Practice Location Address
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Address Line | 26576 AVENIDA DESEO
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City | MISSION VIEJO
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State | CA
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Zip | 92691-3304
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Country | US
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Telephone | 949-538-8111
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Fax |
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Provider Business Mailing Address
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Address Line | 24000 ALICIA PARKWAY STE 17, BOX 234
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City | MISSION VIEJO
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State | CA
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Zip | 92691
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Country | US
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Telephone | 949-215-9995
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JEFFREY MONTANARI
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Credential |
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Telephone | 949-538-8111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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