Healthcare Provider Details

I. General information

NPI: 1649225632
Provider Name (Legal Business Name): GENETICS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 SOUTH MAIN STREET SUITE E
ORANGE CA
92868
US

IV. Provider business mailing address

211 SOUTH MAIN STREET SUITE E
ORANGE CA
92868
US

V. Phone/Fax

Practice location:
  • Phone: 714-288-3500
  • Fax: 714-288-3510
Mailing address:
  • Phone: 714-288-3500
  • Fax: 714-288-3510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. TOURAN M ZADEH
Title or Position: MEDICAL DIRECTOR CEO
Credential: MD
Phone: 714-288-3500