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General NPI Number Information
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NPI Number | 1063002087
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Entity Type | Organization
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Legal Business Name | APTITUDE MEDICAL SYSTEMS
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Dates
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Enumeration Date | 01/23/2021
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Last Update Date | 02/03/2021
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Provider Practice Location Address
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Address Line | 125 CREMONA DR STE 100
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City | GOLETA
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State | CA
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Zip | 93117-5503
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Country | US
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Telephone | 415-233-4292
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Fax |
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Provider Business Mailing Address
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Address Line | 125 CREMONA DR STE 100
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City | GOLETA
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State | CA
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Zip | 93117-5503
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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 | COO
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Name | DR. QIANG GONG
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Credential | PHD
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Telephone | 415-233-4292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207SG0203X
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Taxonomy Name | Clinical Molecular Genetics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 246RM2200X
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Taxonomy Name | Medical Laboratory Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 247ZC0005X
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Taxonomy Name | Clinical Laboratory Director (Non-physician)
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License Number |
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License Number State |
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Taxonomy #4
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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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