Provider Demographics
NPI:1942579032
Name:PROBE CLINICAL RESEARCH CORPORATION
Entity Type:Organization
Organization Name:PROBE CLINICAL RESEARCH CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:MANSOUR
Authorized Official - Middle Name:
Authorized Official - Last Name:TAFRESHI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:949-355-4226
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92609-0248
Mailing Address - Country:US
Mailing Address - Phone:714-558-2700
Mailing Address - Fax:714-558-6868
Practice Address - Street 1:1508 N SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-2332
Practice Address - Country:US
Practice Address - Phone:714-558-2700
Practice Address - Fax:714-558-6868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A75501744R1102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744R1102XOther Service ProvidersSpecialistResearch StudyGroup - Multi-Specialty