Basic Information
Provider Information
NPI: 1881853976
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HALIM
FirstName: ANNE
MiddleName: MARIE
NamePrefix: MS.
NameSuffix:  
Credential: RADIOLOGY TECH.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 659 S CENTRAL VALLEY HWY
Address2:  
City: SHAFTER
State: CA
PostalCode: 932632790
CountryCode: US
TelephoneNumber: 6614591913
FaxNumber: 6614591974
Practice Location
Address1: 2101 7TH ST
Address2:  
City: WASCO
State: CA
PostalCode: 932801502
CountryCode: US
TelephoneNumber: 6617582263
FaxNumber: 6617588132
Other Information
ProviderEnumerationDate: 06/04/2008
LastUpdateDate: 06/04/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
247100000X227939CAY Technologists, Technicians & Other Technical Service ProvidersRadiologic Technologist 

No ID Information.


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