NPI Code Detail JSON Logo

1477912574 NPI number — RENOVARI, INC

NPI Number: 1477912574
Health Care Provider/Practitioner: RENOVARI, INC

Information about “1477912574” NPI (RENOVARI, INC) exists in 1477912574 in HTML format HTML  |  1477912574 in plain Text format TXT  |  1477912574 in PDF (Portable Document Format) PDF  |  1477912574 in an XML format XML  formats.

NPI Number : 1477912574 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1477912574",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "RENOVARI, INC",
    "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": "2950 E IMPERIAL HWY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BREA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92821-6715",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "714-833-2472",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2950 E IMPERIAL HWY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BREA",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92821-6715",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "714-833-2472",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/17/2016",
    "LastUpdateDate": "02/17/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "WILLIAMS",
    "AuthorizedOfficialFirstName": "CHRISTOPHER",
    "AuthorizedOfficialMiddleName": "MICHAEL",
    "AuthorizedOfficialTitle": "PRINCIPLE",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LMFT",
    "AuthorizedOfficialTelephoneNumber": "714-833-2472",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "305S00000X",
        "TaxonomyName": "Point of Service",
        "LicenseNumber": "52007",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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