Healthcare Provider Details
I. General information
NPI: 1851088389
Provider Name (Legal Business Name): NCEPT DIAGNOSTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/24/2023
Last Update Date: 02/05/2024
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
457 N ELM ST
ESCONDIDO CA
92025-3001
US
IV. Provider business mailing address
457 N ELM ST
ESCONDIDO CA
92025-3001
US
V. Phone/Fax
- Phone: 760-489-1969
- Fax: 760-489-5226
- Phone: 760-489-1969
- Fax: 760-489-5226
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251E1300X |
| Taxonomy | Clinical Electrophysiology Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SKYE
GRAYSON
Title or Position: OWNER, CEO
Credential: DPT
Phone: 760-489-1969