Healthcare Provider Details

I. General information

NPI: 1598363335
Provider Name (Legal Business Name): RJM DIAGNOSTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2020
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1045 ATLANTIC AVE STE 616
LONG BEACH CA
90813-3411
US

IV. Provider business mailing address

1045 ATLANTIC AVE STE 616
LONG BEACH CA
90813-3411
US

V. Phone/Fax

Practice location:
  • Phone: 562-436-4473
  • Fax: 562-437-6937
Mailing address:
  • Phone: 562-283-8486
  • Fax: 562-352-2146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2278P1004X
TaxonomyPulmonary Diagnostics Certified Respiratory Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2279P1004X
TaxonomyPulmonary Diagnostics Registered Respiratory Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2279P1006X
TaxonomyPulmonary Function Technologist Registered Respiratory Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MAURICIO HERNANDEZ
Title or Position: PULMONARY FUNCTION TEHNICIAN
Credential: RCP, RRT
Phone: 626-698-8613