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General NPI Number Information
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NPI Number | 1124970058
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Entity Type | Organization
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Legal Business Name | NONAGEN BIOSCIENCE CORP
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Dates
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Enumeration Date | 02/12/2026
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 15375 BARRANCA PKWY STE E101
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City | IRVINE
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State | CA
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Zip | 92618-2207
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Country | US
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Telephone | 949-844-7109
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Fax | 949-844-7227
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Provider Business Mailing Address
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Address Line | 15375 BARRANCA PKWY STE E101
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City | IRVINE
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State | CA
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Zip | 92618-2207
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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 | CEO
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Name | DR. CHARLES JOEL ROSSER
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Credential | MD, MBA
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Telephone | 713-806-3973
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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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