Healthcare Provider Details

I. General information

NPI: 1144649880
Provider Name (Legal Business Name): SKILLTECH DX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2014
Last Update Date: 07/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 VAL VERDE DR
WEST HILLS CA
91304-2135
US

IV. Provider business mailing address

8500 VAL VERDE DR
WEST HILLS CA
91304-2135
US

V. Phone/Fax

Practice location:
  • Phone: 818-986-8800
  • Fax: 818-986-8801
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN YAKER
Title or Position: CEO
Credential:
Phone: 800-967-3309