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1750665170 NPI number — TINA M BAIZA

NPI Number: 1750665170
Health Care Provider/Practitioner: TINA M BAIZA

Information about “1750665170” NPI (TINA M BAIZA) exists in 1750665170 in HTML format HTML  |  1750665170 in plain Text format TXT  |  1750665170 in PDF (Portable Document Format) PDF  |  1750665170 in an XML format XML  formats.

NPI Number : 1750665170 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1750665170",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BAIZA",
    "FirstName": "TINA",
    "MiddleName": "M",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MOREN",
    "OtherFirstName": "TINA",
    "OtherMiddleName": "M",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "5865 PALMILLA ST UNIT 7",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NORTH LAS VEGAS",
    "MailingAddressStateName": "NV",
    "MailingAddressPostalCode": "89031-4131",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "510-725-7162",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2801 S VALLEY VIEW BLVD STE 6",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LAS VEGAS",
    "PracticeLocationAddressStateName": "NV",
    "PracticeLocationAddressPostalCode": "89102-0166",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "702-922-7015",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/04/2011",
    "LastUpdateDate": "08/30/2017",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225400000X",
        "TaxonomyName": "Rehabilitation Practitioner",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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