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General NPI Number Information
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NPI Number | 1043981327
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Entity Type | Organization
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Legal Business Name | TIB DIAGNOSTICS LLC
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Dates
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Enumeration Date | 09/25/2021
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Last Update Date | 09/25/2021
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Provider Practice Location Address
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Address Line | 1799 BAYSHORE HWY STE 217
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City | BURLINGAME
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State | CA
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Zip | 94010-1312
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Country | US
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Telephone | 650-240-3435
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Fax |
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Provider Business Mailing Address
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Address Line | 42808 CHRISTY ST STE 102
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City | FREMONT
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State | CA
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Zip | 94538-3156
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | NAWEED MUHAMMAD
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Credential |
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Telephone | 408-313-7957
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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 |
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License Number State |
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