Healthcare Provider Details

I. General information

NPI: 1982966172
Provider Name (Legal Business Name): HEALTH DIAGNOSTICS OF CALIFORNIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2012
Last Update Date: 01/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14651 S BASCOM AVE SUITE 120
LOS GATOS CA
95032-2014
US

IV. Provider business mailing address

PO BOX 203557
DALLAS TX
75320-3557
US

V. Phone/Fax

Practice location:
  • Phone: 408-356-9013
  • Fax: 408-356-9014
Mailing address:
  • Phone: 888-685-3910
  • Fax: 800-508-4751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HOWARD J. SIMON
Title or Position: OWNER
Credential: M.D.
Phone: 480-264-2400