NPI Code Detail JSON Logo

1558950022 NPI number — INTEGRATED HOME DIALYSIS STAFF ASSISTANT LLC

NPI Number: 1558950022
Health Care Provider/Practitioner: INTEGRATED HOME DIALYSIS STAFF ASSISTANT LLC

Information about “1558950022” NPI (INTEGRATED HOME DIALYSIS STAFF ASSISTANT LLC) exists in 1558950022 in HTML format HTML  |  1558950022 in plain Text format TXT  |  1558950022 in PDF (Portable Document Format) PDF  |  1558950022 in an XML format XML  formats.

NPI Number : 1558950022 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1558950022",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "INTEGRATED HOME DIALYSIS STAFF ASSISTANT 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": "PO BOX 76016",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LOS ANGELES",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90076-0016",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "310-614-8740",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1507 ROSS ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "POMONA",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "91767-4246",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "310-614-8740",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/11/2021",
    "LastUpdateDate": "01/11/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "OBEMBE",
    "AuthorizedOfficialFirstName": "SAM",
    "AuthorizedOfficialMiddleName": "O",
    "AuthorizedOfficialTitle": "CFO",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "310-614-8740",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "2472R0900X",
        "TaxonomyName": "Renal Dialysis Technician",
        "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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