Provider Demographics
NPI:1124356043
Name:CHJ DIAGNOSTIC, INC.
Entity Type:Organization
Organization Name:CHJ DIAGNOSTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVONIANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-568-0006
Mailing Address - Street 1:550 E CHAPMAN AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-1641
Mailing Address - Country:US
Mailing Address - Phone:714-602-7374
Mailing Address - Fax:714-602-7388
Practice Address - Street 1:550 E CHAPMAN AVE
Practice Address - Street 2:SUITE E
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-1641
Practice Address - Country:US
Practice Address - Phone:714-602-7374
Practice Address - Fax:714-602-7388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-04
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center