Provider Demographics
NPI:1497412084
Name:DIAGNOSTICS IN MOTION, LLC
Entity Type:Organization
Organization Name:DIAGNOSTICS IN MOTION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SELLERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-392-7767
Mailing Address - Street 1:1090 LAWRENCE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-1315
Mailing Address - Country:US
Mailing Address - Phone:805-852-7031
Mailing Address - Fax:805-277-9532
Practice Address - Street 1:1090 LAWRENCE DR STE 102
Practice Address - Street 2:
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320-1315
Practice Address - Country:US
Practice Address - Phone:805-852-7031
Practice Address - Fax:805-277-9532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty