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General NPI Number Information
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NPI Number | 1912289133
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Entity Type | Organization
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Legal Business Name | OVAGENE ONCOLOGY, INC.
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Dates
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Enumeration Date | 09/14/2011
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Last Update Date | 09/14/2011
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Provider Practice Location Address
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Address Line | 10 PASTEUR SUITE 150
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City | IRVINE
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State | CA
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Zip | 92618-3824
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Country | US
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Telephone | 949-748-6415
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Fax | 949-861-7195
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Provider Business Mailing Address
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Address Line | 10 PASTEUR SUITE 150
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City | IRVINE
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State | CA
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Zip | 92618-3824
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Country | US
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Telephone | 949-748-6415
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Fax | 949-861-7195
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Authorized Official
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Title or Position | CEO
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Name | MR. FRANK KIESNER
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Credential | J.D.
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Telephone | 949-271-8810
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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 | CLF00341215
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License Number State | CA
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