NPI Code Detail JSON Logo

1932716123 NPI number — PHOEBE PULIDO PA-C

NPI Number: 1932716123
Health Care Provider/Practitioner: PHOEBE PULIDO PA-C

Information about “1932716123” NPI (PHOEBE PULIDO PA-C) exists in 1932716123 in HTML format HTML  |  1932716123 in plain Text format TXT  |  1932716123 in PDF (Portable Document Format) PDF  |  1932716123 in an XML format XML  formats.

NPI Number : 1932716123 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1932716123",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PULIDO",
    "FirstName": "PHOEBE",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PA-C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "NGOY",
    "OtherFirstName": "PHOEBE",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "5075 ROCKHAMPTON CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "YORBA LINDA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92887-2621",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "33494 OAK GLEN RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "YUCAIPA",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92399-2057",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "909-797-8900",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/30/2020",
    "LastUpdateDate": "09/30/2020",
    "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": "363A00000X",
        "TaxonomyName": "Physician Assistant",
        "LicenseNumber": "1178392",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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