Provider Demographics
NPI:1346366473
Name:PINNACLE NEURO DIAGNOSTIC
Entity Type:Organization
Organization Name:PINNACLE NEURO DIAGNOSTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:CAROLYN
Authorized Official - Last Name:CARMICHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-926-8331
Mailing Address - Street 1:36413 ROTTERDAM ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:CA
Mailing Address - Zip Code:92596-9237
Mailing Address - Country:US
Mailing Address - Phone:951-926-8331
Mailing Address - Fax:951-926-5221
Practice Address - Street 1:36413 ROTTERDAM ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:CA
Practice Address - Zip Code:92596-9237
Practice Address - Country:US
Practice Address - Phone:951-926-8331
Practice Address - Fax:951-926-5221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty