Initial Innovative Blood, LLC

Primary specialty

Technician/TechnologistTaxonomy code 156F00000X

Legal business name

INITIAL INNOVATIVE BLOOD, LLC

Doing business as

Initial Innovative Blood, LLC

Practice address

16481 Waterway Cir Apt B
Huntington Beach, CA 92649-3256

Phone

(714) 209-9009

Fax

(714) 384-7233

NPI assigned

Mar 26, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Alfred SamuelNPI 1063098143

Title

Ceo

Phone

(714) 209-9009

Specialties & licenses 1

Addresses

Other names 1

• Initial Innovative Blood, LLC Doing business as

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alfred Samuel

  • Technician/Technologist
  • Huntington Beach, CA
  • NPI 1063098143
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616716800000",
    "number": "1437736295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16481 WATERWAY CIR APT B",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926493256",
            "telephone_number": "714-209-9009",
            "fax_number": "714-384-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16481 WATERWAY CIR APT B",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926493256",
            "telephone_number": "714-209-9009",
            "fax_number": "714-384-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INITIAL INNOVATIVE BLOOD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-26",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A",
        "authorized_official_last_name": "SAMUEL",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-209-9009",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "156F00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "initialinnovative.blood@gmail.com",
            "affiliation": "N",
            "address_1": "16481 Waterway Cir Apt B",
            "city": "Huntington Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926493256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Initial Innovative Blood, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Technician/Technologist in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Technician/Technologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.