Healthcare Provider Details

I. General information

NPI: 1629599733
Provider Name (Legal Business Name): CARE CHOPO DIAGNOSTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2017
Last Update Date: 06/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HIDALGO 79
GUADALAJARA MEXICO
45920
MX

IV. Provider business mailing address

HIDALGO 79
GUADALAJARA MEXICO
45920
MX

V. Phone/Fax

Practice location:
  • Phone: 888-449-7799
  • Fax: 888-449-7799
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RM2200X
TaxonomyMedical Laboratory Technician
License Number
License Number State

VIII. Authorized Official

Name: MRS. EVA AGUIRE
Title or Position: MANAGER
Credential:
Phone: 888-449-7799