Modification Network, Inc.

Primary specialty

Home Modifications ContractorTaxonomy code 171WH0202X

Legal business name

MODIFICATION NETWORK, INC.

Practice address

17662 Irvine Blvd Ste 20
Tustin, CA 92780-3133

Phone

(714) 881-1616

NPI assigned

Feb 26, 2020

Organization subpart

No

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

Authorized official

Name

Joseph Christian Bolohan

Title

President

Phone

(714) 881-1616

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582675200000",
    "number": "1508490749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17662 IRVINE BLVD STE 20",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803133",
            "telephone_number": "714-881-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17662 IRVINE BLVD STE 20",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803133",
            "telephone_number": "714-881-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODIFICATION NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-26",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A",
        "authorized_official_last_name": "BOLOHAN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "CHRISTIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-881-1616"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Contractor, Home Modifications",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Modifications Contractor in Tustin, CA
• Providers in Tustin, CA by specialty
• Home Modifications Contractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; 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.