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1528347176 NPI number — ICI 24 7 PC

NPI Number: 1528347176
Health Care Provider/Practitioner: ICI 24 7 PC

Information about “1528347176” NPI (ICI 24 7 PC) exists in 1528347176 in HTML format HTML  |  1528347176 in plain Text format TXT  |  1528347176 in PDF (Portable Document Format) PDF  |  1528347176 in an XML format XML  formats.

NPI Number : 1528347176 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1528347176",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ICI 24 7 PC",
    "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": "100 BAYVIEW CIR",
    "SecondLineMailingAddress": "SUITE 400",
    "MailingAddressCityName": "NEWPORT BEACH",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92660-2983",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "949-242-5300",
    "MailingAddressFaxNumber": "949-242-5397",
    "FirstLinePracticeLocationAddress": "5820 OBERLIN DR",
    "SecondLinePracticeLocationAddress": "SUITE 205",
    "PracticeLocationAddressCityName": "SAN DIEGO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92121-3742",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "858-453-9729",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/15/2011",
    "LastUpdateDate": "08/15/2011",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BLOOM",
    "AuthorizedOfficialFirstName": "DAVID",
    "AuthorizedOfficialMiddleName": "L",
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "M.D.,",
    "AuthorizedOfficialTelephoneNumber": "978-552-2732",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "2085R0202X",
        "TaxonomyName": "Diagnostic Radiology Physician",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

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