=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700997293
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NOLAN T. HIGA, MD, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/31/2006
-----------------------------------------------------
Last Update Date | 07/07/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 860 OAK PARK BLVD SUITE 102
-----------------------------------------------------
City | ARROYO GRANDE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93420-1800
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-928-1731
-----------------------------------------------------
Fax | 805-349-8160
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 6406
-----------------------------------------------------
City | SANTA MARIA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93456-6406
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-928-1731
-----------------------------------------------------
Fax | 805-349-8160
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | TRACY MORENO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 805-928-1731
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------