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General NPI Number Information
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NPI Number | 1326206103
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Entity Type | Organization
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Legal Business Name | 3D PRINTING INC.
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Dates
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Enumeration Date | 05/28/2008
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Last Update Date | 08/29/2008
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Provider Practice Location Address
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Address Line | 23352 EL TORO RD
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City | LAKE FOREST
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State | CA
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Zip | 92630-4807
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Country | US
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Telephone | 949-583-1490
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Fax | 949-583-1314
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Provider Business Mailing Address
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Address Line | 23352 EL TORO RD
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City | LAKE FOREST
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State | CA
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Zip | 92630-4807
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Country | US
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Telephone | 949-583-1490
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Fax | 949-583-1314
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SEMIWATI TAN
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Credential | M.B.A
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Telephone | 949-583-1490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 20076118057
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License Number State | CA
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