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General NPI Number Information
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NPI Number | 1306104864
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Entity Type | Organization
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Legal Business Name | AMERICAN INDUSTRIAL LABORATORIES LLC
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Dates
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Enumeration Date | 05/02/2012
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Last Update Date | 12/08/2014
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Provider Practice Location Address
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Address Line | 21163 NEWPORT COAST DR STE 500
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City | NEWPORT COAST
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State | CA
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Zip | 92657-1123
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Country | US
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Telephone | 949-829-1170
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 13302
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City | NEWPORT BEACH
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State | CA
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Zip | 92658-5092
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Country | US
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Telephone | 949-829-1170
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Fax |
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Authorized Official
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Title or Position | COO
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Name | FRANK HAMADANI
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Credential |
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Telephone | 949-829-1170
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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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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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