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General NPI Number Information
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NPI Number | 1164305678
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Entity Type | Organization
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Legal Business Name | INTELLIGENCE DX LLC
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Dates
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Enumeration Date | 07/30/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 6101 S RURAL RD STE 112
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City | TEMPE
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State | AZ
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Zip | 85283-2910
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Country | US
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Telephone | 949-205-3659
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Fax | 833-773-8862
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Provider Business Mailing Address
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Address Line | 16478 BEACH BLVD
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City | WESTMINSTER
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State | CA
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Zip | 92683-7860
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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 | WENDY MOVSESIAN
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Credential |
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Telephone | 949-205-3659
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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