Provider Demographics
NPI:1568118164
Name:DASH DIAGNOSTICS MEDICAL
Entity Type:Organization
Organization Name:DASH DIAGNOSTICS MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HEIMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-501-5501
Mailing Address - Street 1:2618 SAN MIGUEL DR # 470
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5437
Mailing Address - Country:US
Mailing Address - Phone:800-850-2693
Mailing Address - Fax:
Practice Address - Street 1:14014 MILBANK ST UNIT 5
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-2984
Practice Address - Country:US
Practice Address - Phone:800-850-2693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service