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General NPI Number Information
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NPI Number | 1184834038
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Entity Type | Organization
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Legal Business Name | BIOMEGA CORPORATION
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4426 CERRITOS AVE
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-2549
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Country | US
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Telephone | 714-761-7200
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Fax | 714-761-5225
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Provider Business Mailing Address
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Address Line | 4426 CERRITOS AVE
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-2549
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Country | US
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Telephone | 714-761-7200
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Fax | 714-761-5225
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Authorized Official
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Title or Position | LABORATORY DIRECTOR
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Name | DR. SUNG H. KIM
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Credential | M.D.
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Telephone | 714-761-7200
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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 | CLF 11218
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License Number State | CA
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