Provider Demographics
NPI:1275252819
Name:D'GENERAL LLC
Entity Type:Organization
Organization Name:D'GENERAL LLC
Other - Org Name:D'GENERAL LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:714-876-3400
Mailing Address - Street 1:421 N BROOKHURST ST STE 228D
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-5619
Mailing Address - Country:US
Mailing Address - Phone:714-876-3400
Mailing Address - Fax:
Practice Address - Street 1:421 N BROOKHURST ST STE 228D
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5619
Practice Address - Country:US
Practice Address - Phone:714-876-3400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-25
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile