Healthcare Provider Details

I. General information

NPI: 1265928212
Provider Name (Legal Business Name): ATS HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2018
Last Update Date: 07/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20271 SW BIRCH ST STE 201
NEWPORT BEACH CA
92660-1752
US

IV. Provider business mailing address

20271 SW BIRCH ST STE 200
NEWPORT BEACH CA
92660-1752
US

V. Phone/Fax

Practice location:
  • Phone: 949-833-8100
  • Fax:
Mailing address:
  • Phone: 949-833-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. KENNY DEWAN
Title or Position: CEO
Credential:
Phone: 949-833-8101