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General NPI Number Information
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NPI Number | 1659969939
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Entity Type | Organization
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Legal Business Name | COVID-19 TESTING CENTERS, INC.
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Dates
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Enumeration Date | 01/04/2021
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Last Update Date | 01/18/2021
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Provider Practice Location Address
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Address Line | 1455 N AVALON BLVD
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City | WILMINGTON
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State | CA
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Zip | 90744-1506
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Country | US
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Telephone | 855-568-4319
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Fax |
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Provider Business Mailing Address
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Address Line | 1455 N AVALON BLVD
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City | WILMINGTON
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State | CA
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Zip | 90744-1506
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Country | US
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Telephone | 855-568-4319
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE
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Name | RICARDO D MIRANDA
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Credential |
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Telephone | 855-568-4319
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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