NPI Code Detail JSON Logo

1447100748 NPI number — PRIME HEALTHCARE SERVICES - SAN DIMAS LLC

NPI Number: 1447100748
Health Care Provider/Practitioner: PRIME HEALTHCARE SERVICES - SAN DIMAS LLC

Information about “1447100748” NPI (PRIME HEALTHCARE SERVICES - SAN DIMAS LLC) exists in 1447100748 in HTML format HTML  |  1447100748 in plain Text format TXT  |  1447100748 in PDF (Portable Document Format) PDF  |  1447100748 in an XML format XML  formats.

NPI Number : 1447100748 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1447100748",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PRIME HEALTHCARE SERVICES - SAN DIMAS LLC",
    "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": "1350 W COVINA BLVD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAN DIMAS",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "91773-3245",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "909-599-6811",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1350 W COVINA BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAN DIMAS",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "91773-3245",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "909-599-6811",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/28/2026",
    "LastUpdateDate": "01/28/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "DOAN",
    "AuthorizedOfficialFirstName": "CHRISTOPHER",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "MANAGING ASSOCIATE GENERAL COUNSEL",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "310-259-4706",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "314000000X",
        "TaxonomyName": "Skilled Nursing Facility",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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