Provider Demographics
NPI:1952068280
Name:ON DEMAND TELEHEALTH A NURSING CORPORATION
Entity Type:Organization
Organization Name:ON DEMAND TELEHEALTH A NURSING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KLAR
Authorized Official - Middle Name:FULGENTES
Authorized Official - Last Name:PASILABAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-813-7979
Mailing Address - Street 1:1822 SPRINGGATE LN APT G
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-2982
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1822 SPRINGGATE LN APT G
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-2982
Practice Address - Country:US
Practice Address - Phone:805-813-7979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-22
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty