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General NPI Number Information
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NPI Number | 1639569692
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Entity Type | Organization
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Legal Business Name | FIRST NATIONAL TOXICOLOGY CORP.
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Dates
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Enumeration Date | 01/29/2015
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Last Update Date | 01/29/2015
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Provider Practice Location Address
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Address Line | 9353 BOLSA AVE # M-29
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City | WESTMINSTER
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State | CA
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Zip | 92683-5951
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Country | US
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Telephone | 714-306-6148
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Fax |
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Provider Business Mailing Address
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Address Line | 9353 BOLSA AVE # M-29
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City | WESTMINSTER
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State | CA
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Zip | 92683-5951
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Country | US
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Telephone | 714-306-6148
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Fax |
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Authorized Official
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Title or Position | C.E.O
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Name | CUONG DO
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Credential |
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Telephone | 714-306-6148
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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 |
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License Number State | CA
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