Healthcare Provider Details
I. General information
NPI: 1275502692
Provider Name (Legal Business Name): INSIGHT HEALTH CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8849 SHELBY ST STE B1
INDIANAPOLIS IN
46227-7508
US
IV. Provider business mailing address
26250 ENTERPRISE CT STE 100
LAKE FOREST CA
92630-8406
US
V. Phone/Fax
- Phone: 317-885-5200
- Fax: 317-885-5209
- Phone: 949-282-6000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 293D00000X |
| Taxonomy | Physiological Laboratory |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
BRIAN
G
DRAZBA
Title or Position: SENIOR V.P. & CHIEF ACCOUNTING OFCR
Credential:
Phone: 949-282-6000