Provider Demographics
NPI:1508663683
Name:GNOSIS FOR HER LLC
Entity type:Organization
Organization Name:GNOSIS FOR HER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-791-7881
Mailing Address - Street 1:300 SPECTRUM CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-4987
Mailing Address - Country:US
Mailing Address - Phone:714-519-6611
Mailing Address - Fax:
Practice Address - Street 1:286 WINFIELD CIR
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92878-4343
Practice Address - Country:US
Practice Address - Phone:714-519-6611
Practice Address - Fax:714-202-6143
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MVML, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile