MEDICARE: HEALTH DIAGNOSTICS OF CALIFORNIA A PROFESSIONAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1225669351
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH DIAGNOSTICS OF CALIFORNIA A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	16220 N SCOTTSDALE RD STE 600
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85254-1804
Country	:	US
Telephone Number	:	480-306-6949
Fax Number	:	602-302-5706

Provider Business Practice Location Address
First Line	:	225 W HOSPITALITY LN STE 100
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92408-3244
Country	:	US
Telephone Number	:	909-890-5856
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	HOWARD JOHN SIMON
Credential	:	MD
Telephone Number	:	480-478-6545

Provider Enumeration Date	:	01/28/2020
Last Update Date	:	05/01/2024

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