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General NPI Number Information
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NPI Number | 1720266174
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Entity Type | Organization
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Legal Business Name | APMG MOLECULAR DIAGNOSTICS
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Dates
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Enumeration Date | 02/07/2008
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Last Update Date | 02/07/2008
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Provider Practice Location Address
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Address Line | 5565 GROSSMONT CENTER DR BUILDING #1, SUITE 211
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City | LA MESA
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State | CA
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Zip | 91942-3020
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Country | US
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Telephone | 619-507-1658
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Fax |
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Provider Business Mailing Address
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Address Line | 5565 GROSSMONT CENTER DR BUILDING #1, SUITE 211
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City | LA MESA
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State | CA
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Zip | 91942-3020
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Country | US
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Telephone | 619-507-1658
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Fax |
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Authorized Official
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Title or Position | PATHOLOGIST/CEO
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Name | DR. OCTAVIO ARMAS
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Credential | M.D.
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Telephone | 619-507-1658
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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 | PENDING
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License Number State | CA
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