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General NPI Number Information
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NPI Number | 1568118164
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Entity Type | Organization
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Legal Business Name | DASH DIAGNOSTICS MEDICAL
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Dates
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Enumeration Date | 02/23/2022
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Last Update Date | 02/23/2022
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Provider Practice Location Address
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Address Line | 14014 MILBANK ST UNIT 5
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City | SHERMAN OAKS
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State | CA
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Zip | 91423-2984
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Country | US
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Telephone | 800-850-2693
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Fax |
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Provider Business Mailing Address
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Address Line | 2618 SAN MIGUEL DR # 470
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-5437
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Country | US
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Telephone | 800-850-2693
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MISS RICHARD HEIMANN
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Credential |
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Telephone | 714-501-5501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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