Provider Demographics
NPI:1285018986
Name:PLATINUM HEALTH CENTER
Entity Type:Organization
Organization Name:PLATINUM HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONENIC
Authorized Official - Middle Name:
Authorized Official - Last Name:SIGNORELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:714-543-3500
Mailing Address - Street 1:245 E OLIVE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1223
Mailing Address - Country:US
Mailing Address - Phone:714-543-3500
Mailing Address - Fax:866-379-7438
Practice Address - Street 1:1125 E 17TH ST STE E101
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701
Practice Address - Country:US
Practice Address - Phone:714-543-3500
Practice Address - Fax:866-379-7438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-13
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4065213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Multi-Specialty