NPI |
1437762119 |
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. |
Entity Type Code |
1 |
The city name in the location address of the provider being identified. |
Provider Last Name Legal Name |
MORFIN |
The State code in the location of the provider
being identified. |
Provider First Name |
ISSAMAR |
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 First Line Business Practice Location Address |
44 GOUGH ST STE 210 |
The country code in the location address of the provider being identified. |
Provider Business Practice Location Address City Name |
SAN FRANCISCO |
The telephone number associated with the location address of the provider being identified. |
Provider Business Practice Location Address State Name |
CA |
The fax number associated with the location
address of the provider being identified. |
Provider Business Practice Location Address Postal Code |
941035424 |
The date the provider was assigned a unique identifier (assigned an NPI). |
Provider Business Practice Location Address Country Code If outside U S |
US |
The date that a record was last updated or changed. |
Provider Business Practice Location Address Telephone Number |
7168297323 |
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider. |
Provider Enumeration Date |
8/24/2020 |
The first name of the authorized official. |
Last Update Date |
8/24/2020 |
The date that a record was last updated or changed. |
Provider Gender Code |
F |
The code designating the provider’s gender if the provider is a person. |
Healthcare Provider Taxonomy Code 1 |
106S00000X |
The code designating the provider’s gender if the provider is a person. |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
|
Is Sole Proprietor |
N |
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No |
NPI Certification Date |
8/24/2020 |
|