Provider Demographics
NPI:1083095145
Name:VIRTOUS EXPRESS
Entity Type:Organization
Organization Name:VIRTOUS EXPRESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHLEBOTOMY
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-400-2163
Mailing Address - Street 1:4361 W 137TH ST
Mailing Address - Street 2:SUITE #5
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-1003
Mailing Address - Country:US
Mailing Address - Phone:310-400-2163
Mailing Address - Fax:
Practice Address - Street 1:4361 W 137TH ST
Practice Address - Street 2:SUITE #5
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-1003
Practice Address - Country:US
Practice Address - Phone:310-400-2163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIRTUOUS EXPRESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty