Provider Demographics
NPI:1033629696
Name:NEXTGEN LABORATORIES, INC.
Entity Type:Organization
Organization Name:NEXTGEN LABORATORIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:DEL SIGNORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-800-4900
Mailing Address - Street 1:4229 BIRCH ST STE 130
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-1960
Mailing Address - Country:US
Mailing Address - Phone:661-800-4900
Mailing Address - Fax:661-846-2696
Practice Address - Street 1:2020 20TH ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301
Practice Address - Country:US
Practice Address - Phone:661-800-4900
Practice Address - Fax:661-846-2696
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEXTGEN LABORATORIES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-09
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACLR349814291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACLR349814OtherCALIFORNIA DEPARTMENT OF PUBLIC HEALTH