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1326169996 NPI number — AMERICAN CARDIO LABS

NPI Number: 1326169996
Health Care Provider/Practitioner: AMERICAN CARDIO LABS

Information about “1326169996” NPI (AMERICAN CARDIO LABS) exists in 1326169996 in HTML format HTML  |  1326169996 in plain Text format TXT  |  1326169996 in PDF (Portable Document Format) PDF  |  1326169996 in an XML format XML  formats.

NPI Number : 1326169996 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1326169996",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "AMERICAN CARDIO LABS",
    "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": "27702 CROWN VALLEY PKWY # D4-150",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LADERA RANCH",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92694-0608",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "800-200-4225",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "17 ELMHURST ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LADERA RANCH",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92694-0850",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "800-200-4225",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/02/2007",
    "LastUpdateDate": "10/13/2010",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ROELOFS",
    "AuthorizedOfficialFirstName": "BRAD",
    "AuthorizedOfficialMiddleName": "J.",
    "AuthorizedOfficialTitle": "MANAGER",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "CCT",
    "AuthorizedOfficialTelephoneNumber": "800-200-4225",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "293D00000X",
        "TaxonomyName": "Physiological Laboratory",
        "LicenseNumber": "TG033",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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