Provider Demographics
NPI:1982007670
Name:HEALTH DIAGNOSTICS OF CALIFORNIA, LLC
Entity Type:Organization
Organization Name:HEALTH DIAGNOSTICS OF CALIFORNIA, LLC
Other - Org Name:SAN FRANCISCO SFMRC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-651-1945
Mailing Address - Street 1:1180 POST STREET
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109
Mailing Address - Country:US
Mailing Address - Phone:415-248-3700
Mailing Address - Fax:650-257-6233
Practice Address - Street 1:1180 POST ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5505
Practice Address - Country:US
Practice Address - Phone:415-248-3700
Practice Address - Fax:650-257-6233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-08
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PENDINGMedicare PIN