Provider Demographics
NPI:1417146317
Name:NEW HORIZON MEDICAL CORP.
Entity Type:Organization
Organization Name:NEW HORIZON MEDICAL CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-402-2811
Mailing Address - Street 1:21520 PIONEER BLVD
Mailing Address - Street 2:#202
Mailing Address - City:HAWAIIAN GARDENS
Mailing Address - State:CA
Mailing Address - Zip Code:90716-2603
Mailing Address - Country:US
Mailing Address - Phone:562-402-2811
Mailing Address - Fax:562-402-1505
Practice Address - Street 1:21520 PIONEER BLVD
Practice Address - Street 2:#202
Practice Address - City:HAWAIIAN GARDENS
Practice Address - State:CA
Practice Address - Zip Code:90716-2603
Practice Address - Country:US
Practice Address - Phone:562-402-2811
Practice Address - Fax:562-402-1505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA52009174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF64660Medicare UPIN
CAW14138Medicare PIN