NPI Code Detail JSON Logo

1073101028 NPI number — QUICKMED DIAGNOSTIC, INC.

NPI Number: 1073101028
Health Care Provider/Practitioner: QUICKMED DIAGNOSTIC, INC.

Information about “1073101028” NPI (QUICKMED DIAGNOSTIC, INC.) exists in 1073101028 in HTML format HTML  |  1073101028 in plain Text format TXT  |  1073101028 in PDF (Portable Document Format) PDF  |  1073101028 in an XML format XML  formats.

NPI Number : 1073101028 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1073101028",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "QUICKMED DIAGNOSTIC, INC.",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5930 W JEFFERSON BLVD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LOS ANGELES",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90016-4306",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "310-905-6441",
    "MailingAddressFaxNumber": "213-559-0676",
    "FirstLinePracticeLocationAddress": "5930 W JEFFERSON BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LOS ANGELES",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "90016-4306",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "310-905-6441",
    "PracticeLocationAddressFaxNumber": "213-559-0676",
    "EnumerationDate": "01/05/2021",
    "LastUpdateDate": "03/11/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SAVVIDES",
    "AuthorizedOfficialFirstName": "MICHAEL",
    "AuthorizedOfficialMiddleName": "GEORGE",
    "AuthorizedOfficialTitle": "VP OF OPERATIONS",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "310-905-6441",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "291U00000X",
        "TaxonomyName": "Clinical Medical Laboratory",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.