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General NPI Number Information
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NPI Number | 1023906971
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Entity Type | Organization
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Legal Business Name | NETWORK DIAGNOSTICS LLC
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Dates
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Enumeration Date | 06/26/2025
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 2041 W BONANZA RD
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City | LAS VEGAS
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State | NV
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Zip | 89106-4766
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Country | US
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Telephone | 650-537-1598
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Fax | 650-887-1689
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Provider Business Mailing Address
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Address Line | 2041 W BONANZA RD
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City | LAS VEGAS
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State | NV
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Zip | 89106-4766
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Country | US
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Telephone | 650-537-1598
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. MARK MILLER
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Credential | DPM
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Telephone | 702-524-0367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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