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General NPI Number Information
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NPI Number | 1871826636
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Entity Type | Organization
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Legal Business Name | PRIMARY HEALTH CARE SERVICES DIAGNOSTICS
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Dates
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Enumeration Date | 09/11/2009
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Last Update Date | 09/11/2009
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Provider Practice Location Address
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Address Line | 2920 F ST #D
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City | BAKERSFIELD
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State | CA
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Zip | 93301-1845
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Country | US
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Telephone | 661-374-4945
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Fax | 661-374-4963
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Provider Business Mailing Address
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Address Line | 2920 F ST #D
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City | BAKERSFIELD
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State | CA
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Zip | 93301-1845
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Country | US
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Telephone | 661-374-4945
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Fax | 661-374-4963
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Authorized Official
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Title or Position | PRESIDENT
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Name | NAZAREY VANDANYAN
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Credential |
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Telephone | 323-382-4763
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246Z00000X
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Taxonomy Name | Other Specialist/Technologist
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License Number | 115197
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License Number State | CA
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