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NPI Code Detail

MEDICARE: CYTOGEN LABS, INC

MEDICARE: CYTOGEN LABS, 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
1291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1851877989
Entity Type Code : Organization
Provider Name (Legal Business Name) : CYTOGEN LABS, INC
Provider Business Mailing Address
First Line : 2183 FAIRVIEW RD
Second Line :
City : COSTA MESA
State : CA
Zip : 92627-5663
Country : US
Telephone Number : 714-470-4265
Fax Number :
Provider Business Practice Location Address
First Line : 2183 FAIRVIEW RD STE 100
Second Line :
City : COSTA MESA
State : CA
Zip : 92627-5671
Country : US
Telephone Number : 949-244-4500
Fax Number :
Authorized Official
Title or Position : CEO
Name : IAN KUEMERLE
Credential :
Telephone Number : 714-470-4265
Provider Enumeration Date : 07/11/2018
Last Update Date : 05/12/2020

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Directions to “CYTOGEN LABS, INC ” Practice Location

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