Healthcare Provider Details

I. General information

NPI: 1851187835
Provider Name (Legal Business Name): NEEDLES ON WHEELS MOBILE PHLEBOTOMY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7869 VENTURA CANYON AVE UNIT 202
PANORAMA CITY CA
91402-6361
US

IV. Provider business mailing address

7869 VENTURA CANYON AVE UNIT 202
PANORAMA CITY CA
91402-6361
US

V. Phone/Fax

Practice location:
  • Phone: 818-731-1009
  • Fax:
Mailing address:
  • Phone: 818-731-1009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: DOMINGO H TIAMZON JR.
Title or Position: MANAGER/OWNER
Credential:
Phone: 818-731-1009