Provider Demographics
NPI:1538503438
Name:NEW GENERATION DIAGNOSTICS
Entity Type:Organization
Organization Name:NEW GENERATION DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-359-1097
Mailing Address - Street 1:15800 WOODVALE RD
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-3443
Mailing Address - Country:US
Mailing Address - Phone:818-359-1097
Mailing Address - Fax:
Practice Address - Street 1:6700 FALLBROOK AVE STE 203C
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-3549
Practice Address - Country:US
Practice Address - Phone:818-359-1097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory