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General NPI Number Information
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NPI Number | 1104296268
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Entity Type | Organization
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Legal Business Name | EXPER-TECH
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Dates
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Enumeration Date | 10/01/2015
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Last Update Date | 10/01/2015
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Provider Practice Location Address
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Address Line | 913 LINDENCLIFF ST
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City | TORRANCE
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State | CA
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Zip | 90502-2710
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Country | US
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Telephone | 805-705-5003
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Fax |
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Provider Business Mailing Address
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Address Line | 913 LINDENCLIFF ST
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City | TORRANCE
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State | CA
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Zip | 90502-2710
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Country | US
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Telephone | 805-705-5003
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. GREGG S NIELSON
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Credential | RVT
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Telephone | 805-705-5003
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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 | CA
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