Healthcare Provider Details

I. General information

NPI: 1912727207
Provider Name (Legal Business Name): ECHO WAVES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2024
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 CALIFORNIA AVE STE 100-1
CORONA CA
92881-6470
US

IV. Provider business mailing address

1101 CALIFORNIA AVE STE 100-1
CORONA CA
92881-6470
US

V. Phone/Fax

Practice location:
  • Phone: 562-250-7373
  • Fax:
Mailing address:
  • Phone: 562-250-7373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code246X00000X
TaxonomyCardiovascular Specialist/Technologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. FIEBY ISAAC
Title or Position: CARDIOVASCULAR TECHNOLOGIST
Credential: RDCS, RVT
Phone: 562-250-7373