Provider Demographics
NPI:1710209853
Name:MULTIGEN DIAGNOSTICS INC
Entity Type:Organization
Organization Name:MULTIGEN DIAGNOSTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:THURAIAYAH
Authorized Official - Middle Name:
Authorized Official - Last Name:VINAYAGAMOORTHY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:858-523-1675
Mailing Address - Street 1:11575 SORRENTO VALLEY RD
Mailing Address - Street 2:SUITE # 206
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-1319
Mailing Address - Country:US
Mailing Address - Phone:858-523-1675
Mailing Address - Fax:858-523-1677
Practice Address - Street 1:11575 SORRENTO VALLEY RD
Practice Address - Street 2:SUITE # 206
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1319
Practice Address - Country:US
Practice Address - Phone:858-523-1675
Practice Address - Fax:858-523-1677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-16
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA05D1094618291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory