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General NPI Number Information
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NPI Number | 1548599343
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Entity Type | Organization
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Legal Business Name | PLATINUM GLOBAL DIAGNOSTIC
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Dates
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Enumeration Date | 12/08/2009
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Last Update Date | 02/18/2010
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Provider Practice Location Address
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Address Line | 13337 SOUTH ST #641
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City | CERRITOS
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State | CA
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Zip | 90703-7308
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Country | US
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Telephone | 877-330-3519
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Fax |
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Provider Business Mailing Address
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Address Line | 9901 ARTESIA BLVD
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City | BELLFLOWER
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State | CA
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Zip | 90706
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Country | US
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Telephone | 877-330-3519
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | WINSTON SPELL
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Credential |
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Telephone | 18773303519
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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 | ARDMS 20581
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License Number State | CA
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