Provider Demographics
NPI:1700388766
Name:NORTH VALLEY DIAGNOSTICS SERVICES, INC.
Entity Type:Organization
Organization Name:NORTH VALLEY DIAGNOSTICS SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:MAFFEI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-396-8216
Mailing Address - Street 1:670 SAN FERNANDO MISSION BLVD, #D
Mailing Address - Street 2:
Mailing Address - City:SAN FERNANDO
Mailing Address - State:CA
Mailing Address - Zip Code:91340
Mailing Address - Country:US
Mailing Address - Phone:818-396-8216
Mailing Address - Fax:888-339-6505
Practice Address - Street 1:670 SAN FERNANDO MISSION BLVD, #D
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340
Practice Address - Country:US
Practice Address - Phone:818-396-8216
Practice Address - Fax:888-339-6505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204R00000XAllopathic & Osteopathic PhysiciansElectrodiagnostic MedicineGroup - Single Specialty