Basic Information
Provider Information
NPI: 1285919308
EntityType: 2
ReplacementNPI:  
OrganizationName: HEAD TO TOE HEALTHCARE PLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
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Mailing Information
Address1: 2980 N BEVERLY GLEN CIR
Address2: SUITE 100
City: LOS ANGELES
State: CA
PostalCode: 900771726
CountryCode: US
TelephoneNumber: 3104749809
FaxNumber:  
Practice Location
Address1: 7406 N LA CHOLLA BLVD
Address2:  
City: TUCSON
State: AZ
PostalCode: 857412306
CountryCode: US
TelephoneNumber: 5205450202
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/20/2011
LastUpdateDate: 10/05/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: SHIH
AuthorizedOfficialFirstName: ALAN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 5205450202
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: HEAD TO TOE HEALTHCARE PLC
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: DPM
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332900000X  Y SuppliersNon-Pharmacy Dispensing Site 

No ID Information.


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