1366929481 NPI number — MISS ESTELA RAMIREZ-COTONIETO I RDA 58449

Table of content: MISS ESTELA RAMIREZ-COTONIETO I RDA 58449 (NPI 1366929481)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366929481 NPI number — MISS ESTELA RAMIREZ-COTONIETO I RDA 58449

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAMIREZ-COTONIETO
Provider First Name:
ESTELA
Provider Middle Name:
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
I
Provider Credential Text:
RDA 58449
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366929481
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3815 BALDWIN AVE APT 96
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL MONTE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91731-1736
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-825-0465
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1406 N AZUSA AVE STE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COVINA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91722-1257
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-506-2216
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/21/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 126800000X , with the licence number:  58449 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 58449 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com