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Organization
NISSAN PILEST, MD INC
Active
Organization
NISSAN PILEST, MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DANICA TRAN M.B.A. (BUSINESS MANAGER)
(949) 727-3800
Entity
Organization
Contact information
Practice address
16100 SAND CANYON AVE STE 190, IRVINE, CA 92618-3723
(949) 727-3800
(949) 727-3888
Mailing address
16100 SAND CANYON AVE STE 190, IRVINE, CA 92618-3723
(949) 727-3800
(949) 727-3888
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ58657Z
BLUE SHIELD GROUP PIN
CA
Enumeration date
10/17/2007
Last updated
01/16/2008
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