=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740598986
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DIALMED, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/22/2010
-----------------------------------------------------
Last Update Date | 09/22/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14613 WHITTIER BLVD SUITE 210
-----------------------------------------------------
City | WHITTIER
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90605-1737
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-464-0295
-----------------------------------------------------
Fax | 562-464-0299
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14613 WHITTIER BLVD SUITE 210
-----------------------------------------------------
City | WHITTIER
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90605-1737
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-464-0295
-----------------------------------------------------
Fax | 562-464-0299
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. CHRISTOPHER TODD HARDEMAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 562-464-0295
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------