Healthcare Provider Details

I. General information

NPI: 1679522643
Provider Name (Legal Business Name): INSIGHT HEALTH CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6857 S PULASKI RD
CHICAGO IL
60629-4151
US

IV. Provider business mailing address

26250 ENTERPRISE CT STE 100
LAKE FOREST CA
92630-8406
US

V. Phone/Fax

Practice location:
  • Phone: 773-918-6477
  • Fax: 773-918-6558
Mailing address:
  • Phone: 949-282-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. BRIAN G DRAZBA
Title or Position: SENRIO V.P. & CHIEF ACCOUNTING OFCR
Credential:
Phone: 949-282-6000