MEDICARE: MONARCH DIAGNOSTIC SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1124140777
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONARCH DIAGNOSTIC SERVICES, INC.

Provider Business Mailing Address
First Line	:	18351 BEACH BLVD STE G
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-1347
Country	:	US
Telephone Number	:	714-847-0010
Fax Number	:	714-847-0017

Provider Business Practice Location Address
First Line	:	18351 BEACH BLVD STE G
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-1347
Country	:	US
Telephone Number	:	714-847-0010
Fax Number	:	714-847-0017

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. MICHAEL MENARD
Credential	:	R. NCS. T.
Telephone Number	:	714-847-0010

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	03/15/2022

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