MEDICARE: CURRENT DIAGNOSTICS PROFESSIONAL, LLC

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	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1750812814
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CURRENT DIAGNOSTICS PROFESSIONAL, LLC

Provider Business Mailing Address
First Line	:	1825 PARK ST
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-2734
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1825 PARK ST
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-2734
Country	:	US
Telephone Number	:	714-293-5801
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	MRS. JANET FILSINGER
Credential	:
Telephone Number	:	714-293-5801

Provider Enumeration Date	:	03/21/2017
Last Update Date	:	03/21/2017

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