Healthcare Provider Details

I. General information

NPI: 1568845006
Provider Name (Legal Business Name): DIAGNOSTIC CLINICAL SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2015
Last Update Date: 07/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2617 E CHAPMAN AVE SUITE 101
ORANGE CA
92869-3226
US

IV. Provider business mailing address

5 HOLLAND SUITE 101
IRVINE CA
92618-2566
US

V. Phone/Fax

Practice location:
  • Phone: 714-223-7000
  • Fax: 714-223-7001
Mailing address:
  • Phone: 949-588-2190
  • Fax: 949-588-2199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ALBERT LAI
Title or Position: PRESIDENT/OWNER
Credential: M. D.
Phone: 714-223-7000