ROBERTO CRUZ , NPI 1629395231 — LOS ANGELES (CA)

NPI 1629395231

9+ Years Experience Individual

ROBERTO CRUZ

04/23/2010
PROVIDER ENUMERATION DATE
04/23/2010
LAST UPDATE DATE
1629395231
NPI NUMBER

About ROBERTO CRUZ

Sole proprietor? Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor.

ROBERTO CRUZ is a provider established in LOS ANGELES, CA. The NPI number of ROBERTO CRUZ is 1629395231 and was assigned on 04/23/2010. The practitioners primary taxonomy code is: 171WH0202X .

Mailing address

  • City: LOS ANGELES
  • State: CA
  • Postal code: 90034
  • Phone: 3109093404
  • Address: 10520 NATIONAL BLVD.
  • Address 2: UNIT #301

Primary Practice Address

  • Region : LOS ANGELES, CA
  • NPI : 1629395231
  • Phone : 3109093404
  • Postalcode : 900343668
  • Address : 10520 NATIONAL BLVD UNIT 301

Provider taxonomy - Contractor

  • Taxonomy code: 171WH0202X

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Contacts:

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  • ROBERTO CRUZ
  • Address : 10520 NATIONAL BLVD UNIT 301
  • Region : LOS ANGELES, CA
  • NPI : 1629395231
  • Phone : 3109093404
  • Postalcode : 900343668

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address10520 NATIONAL BLVD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressUNIT 301
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameLOS ANGELES
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameCA
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code900343668
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number3109093404
The telephone number associated with the location address of the provider being identified.
NPI1629395231
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1171WH0202X
Provider Enumeration Date04/23/2010
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated04/23/2010
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)ROBERTO CRUZ
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address10520 NATIONAL BLVD.
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressUNIT #301
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameLOS ANGELES
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameCA
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code90034
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number3109093404
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Healthcare Provider Taxonomy Code #1171WH0202X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Contractor
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorY
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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