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General NPI Number Information
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NPI Number | 1497412084
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Entity Type | Organization
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Legal Business Name | DIAGNOSTICS IN MOTION, LLC
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Dates
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Enumeration Date | 11/18/2021
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Last Update Date | 11/18/2021
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Provider Practice Location Address
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Address Line | 1090 LAWRENCE DR STE 102
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City | NEWBURY PARK
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State | CA
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Zip | 91320-1315
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Country | US
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Telephone | 805-852-7031
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Fax | 805-277-9532
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Provider Business Mailing Address
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Address Line | 1090 LAWRENCE DR STE 102
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City | NEWBURY PARK
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State | CA
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Zip | 91320-1315
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Country | US
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Telephone | 805-852-7031
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Fax | 805-277-9532
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KELLY SELLERS
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Credential |
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Telephone | 877-392-7767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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