Organization Name: | SHIVANAND R POLE MD INC |
NPI Number: | 1598042178 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SHIVANAND RAO POLE (PRESIDENT) |
Mailing Address: | 3851 Katella Avenue 305 Los Alamitos |
State: | CA US |
Postal Code: | 907203915 |
Phone Number: | 5622466061 |
Fax Number: | 5624308600 |
NPI Enumeration Date: | 11/09/2011 |
NPI Last Update Date: | 10/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261Q00000X |
License Number: | A101547 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |