Healthcare Provider Details

I. General information

NPI: 1174932701
Provider Name (Legal Business Name): HEALTH DIAGNOSTICS OF CALIFORNIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2014
Last Update Date: 08/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

665 MUNRAS AVE SUITE 109
MONTEREY CA
93940-3134
US

IV. Provider business mailing address

PO BOX 203557
DALLAS TX
75320-3557
US

V. Phone/Fax

Practice location:
  • Phone: 831-656-9800
  • Fax: 831-656-9801
Mailing address:
  • Phone: 888-685-3909
  • Fax: 800-508-4751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

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