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General NPI Number Information
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NPI Number | 1619337326
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Entity Type | Organization
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Legal Business Name | UC3D LABS, INC
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Dates
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Enumeration Date | 02/24/2016
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Last Update Date | 02/24/2016
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Provider Practice Location Address
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Address Line | 13353 MANGO DR
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City | DEL MAR
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State | CA
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Zip | 92014-3534
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Country | US
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Telephone | 858-353-6961
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 202
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City | DEL MAR
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State | CA
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Zip | 92014-0202
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Country | US
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Telephone | 858-353-6961
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR, PRESIDENT, CEO
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Name | DR. AFSHIN KARIMI
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Credential | MD, JD, PHD
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Telephone | 858-353-6961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A96518
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License Number State | CA
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