Provider Demographics
NPI:1932482270
Name:QUICK DRAW PROFESSIONAL LAB SERVICES
Entity Type:Organization
Organization Name:QUICK DRAW PROFESSIONAL LAB SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHLEBOTOMIST/CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:MILENE
Authorized Official - Middle Name:
Authorized Official - Last Name:UY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-588-9697
Mailing Address - Street 1:3101 S RENE DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-6730
Mailing Address - Country:US
Mailing Address - Phone:714-588-9697
Mailing Address - Fax:
Practice Address - Street 1:3101 S RENE DR
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6730
Practice Address - Country:US
Practice Address - Phone:714-588-9697
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPT00026105251E00000X
CA335013251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health