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General NPI Number Information
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NPI Number | 1801321799
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Entity Type | Organization
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Legal Business Name | NANTHEALTH LABS, LLC
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Dates
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Enumeration Date | 04/27/2017
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Last Update Date | 04/28/2017
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Provider Practice Location Address
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Address Line | 9920 JEFFERSON BLVD
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City | CULVER CITY
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State | CA
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Zip | 90232-3506
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Country | US
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Telephone | 855-949-6268
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Fax |
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Provider Business Mailing Address
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Address Line | 9920 JEFFERSON BLVD
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City | CULVER CITY
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State | CA
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Zip | 90232-3506
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Country | US
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Telephone | 855-949-6268
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | PAUL HOLT
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Credential |
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Telephone | 855-949-6268
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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 |
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