Healthcare Provider Details

I. General information

NPI: 1750510947
Provider Name (Legal Business Name): NEXUS DIAGNOSTICS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2009
Last Update Date: 07/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4070 STERLING WAY
BALDWIN PARK CA
91706-4223
US

IV. Provider business mailing address

4070 STERLING WAY
BALDWIN PARK CA
91706-4223
US

V. Phone/Fax

Practice location:
  • Phone: 626-337-1360
  • Fax: 626-338-3861
Mailing address:
  • Phone: 626-337-1360
  • Fax: 626-338-3861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2471V0105X
TaxonomyVascular Sonography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: MR. ANDRES FERNANDO CARCAMO
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 626-337-1360