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General NPI Number Information
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NPI Number | 1912239856
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Entity Type | Organization
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Legal Business Name | ACCATUR DIAGNOSTICS 1, LLC
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Dates
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Enumeration Date | 02/03/2010
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Last Update Date | 04/10/2018
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Provider Practice Location Address
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Address Line | 1000 LAGUNA RD
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City | PASADENA
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State | CA
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Zip | 91105-2320
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Country | US
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Telephone | 310-720-4664
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 61240
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City | PASADENA
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State | CA
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Zip | 91116-7240
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Country | US
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Telephone | 310-720-4664
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. ELLEN L. PALM-LEIS
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Credential |
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Telephone | 310-720-4664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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