Provider Demographics
NPI:1821332990
Name:TLC MEDICAL DIAGNOSTICS INC.
Entity Type:Organization
Organization Name:TLC MEDICAL DIAGNOSTICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-576-6432
Mailing Address - Street 1:10650 REAGAN ST
Mailing Address - Street 2:1042
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-8800
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4486 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-3763
Practice Address - Country:US
Practice Address - Phone:909-576-6432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment