Provider Demographics
NPI:1619051323
Name:NEW MILLENNIUM DIAGNOSTICS, INC
Entity Type:Organization
Organization Name:NEW MILLENNIUM DIAGNOSTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:REINALDO
Authorized Official - Middle Name:A
Authorized Official - Last Name:BINNS
Authorized Official - Suffix:
Authorized Official - Credentials:RPSG T
Authorized Official - Phone:949-598-4140
Mailing Address - Street 1:24953 PASEO DE VALENCIA STE 20A BLDG A
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-4338
Mailing Address - Country:US
Mailing Address - Phone:949-598-4140
Mailing Address - Fax:949-598-4145
Practice Address - Street 1:24953 PASEO DE VALENCIA STE 20A BLDG A
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-4338
Practice Address - Country:US
Practice Address - Phone:949-598-4140
Practice Address - Fax:949-598-4145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ58298ZOtherBLUE SHIELD PROVIDER ID
CATG082Medicare PIN
CAZZZ58298ZOtherBLUE SHIELD PROVIDER ID