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General NPI Number Information
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NPI Number | 1023317781
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Entity Type | Organization
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Legal Business Name | PHAMATECH INCORPORATED
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Dates
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Enumeration Date | 03/21/2011
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Last Update Date | 04/17/2024
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Provider Practice Location Address
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Address Line | 15175 INNOVATION DRIVE
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City | SAN DIEGO
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State | CA
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Zip | 92128-3401
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Country | US
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Telephone | 858-643-5555
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Fax | 858-635-5843
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Provider Business Mailing Address
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Address Line | 15175 INNOVATION DR
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City | SAN DIEGO
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State | CA
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Zip | 92128-3401
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Country | US
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Telephone | 858-643-5555
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Fax | 858-635-5843
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Authorized Official
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Title or Position | PRESIDENT / CEO
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Name | TUAN H PHAM
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Credential |
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Telephone | 888-635-5840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 05D1078844
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License Number State | CA
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