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General NPI Number Information
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NPI Number | 1386885010
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Entity Type | Organization
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Legal Business Name | DEL MAR DIAGNOSTICS, INC
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Dates
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Enumeration Date | 03/09/2009
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Last Update Date | 03/09/2009
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Provider Practice Location Address
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Address Line | 7839 UNIVERSITY AVE STE 102
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City | LA MESA
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State | CA
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Zip | 91941-4978
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Country | US
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Telephone | 310-717-0167
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Fax | 619-393-0830
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Provider Business Mailing Address
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Address Line | 7839 UNIVERSITY AVE STE 102
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City | LA MESA
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State | CA
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Zip | 91941-4978
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Country | US
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Telephone | 310-717-0167
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Fax | 619-393-0830
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | ANDREY ZAMYATIN
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Credential | MA
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Telephone | 310-717-0167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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