Provider Demographics
NPI:1558637884
Name:DIALCO DIAGNOSTICS GROUP INCORPORATED
Entity Type:Organization
Organization Name:DIALCO DIAGNOSTICS GROUP INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING CONSULTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GATH
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:310-752-3603
Mailing Address - Street 1:8306 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 385
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2382
Mailing Address - Country:US
Mailing Address - Phone:310-752-3603
Mailing Address - Fax:208-975-2296
Practice Address - Street 1:8306 WILSHIRE BLVD
Practice Address - Street 2:SUITE 385
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2382
Practice Address - Country:US
Practice Address - Phone:310-752-3603
Practice Address - Fax:208-975-2296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-30
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEGGroup - Single Specialty
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty
No246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty