Healthcare Provider Details

I. General information

NPI: 1407487531
Provider Name (Legal Business Name): HEALTH DIAGNOSTICS OF CALIFORNIA A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2020
Last Update Date: 05/01/2024
Certification Date: 05/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10111 HOLE AVE
RIVERSIDE CA
92503-3441
US

IV. Provider business mailing address

16220 N SCOTTSDALE RD STE 600
SCOTTSDALE AZ
85254-1804
US

V. Phone/Fax

Practice location:
  • Phone: 951-352-0555
  • Fax:
Mailing address:
  • Phone: 480-306-6949
  • Fax: 602-302-5706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: HOWARD JOHN SIMON
Title or Position: CEO
Credential: MD
Phone: 480-478-6545