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General NPI Number Information
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NPI Number | 1306835038
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Entity Type | Organization
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Legal Business Name | UNIVERSITY DIAGNOTICS, INC.
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Dates
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Enumeration Date | 10/15/2005
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Last Update Date | 08/14/2012
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Provider Practice Location Address
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Address Line | 27725 SANTA MARGARITA PARKWAY SUITE 101
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City | MISSION VIEJO
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State | CA
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Zip | 92691-6706
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Country | US
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Telephone | 949-462-3999
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Fax | 949-462-3777
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Provider Business Mailing Address
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Address Line | 27758 SANTA MARGARITA PARKWAY #409
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City | MISSION VIEJO
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State | CA
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Zip | 92691-6709
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Country | US
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Telephone | 949-364-5716
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Fax | 949-364-5777
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Authorized Official
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Title or Position | OWNER/ MEDICAL DIRECTOR
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Name | SEYED SHAHROKNI
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Credential | M.D.
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Telephone | 949-462-3999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0206X
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Taxonomy Name | Mammography Clinic/Center
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License Number | A67310
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0206X
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Taxonomy Name | Mammography Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | A67310
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License Number State | CA
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