Provider Demographics
NPI:1720266174
Name:APMG MOLECULAR DIAGNOSTICS
Entity Type:Organization
Organization Name:APMG MOLECULAR DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATHOLOGIST/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:OCTAVIO
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-507-1658
Mailing Address - Street 1:5565 GROSSMONT CENTER DR
Mailing Address - Street 2:BUILDING #1, SUITE 211
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-3020
Mailing Address - Country:US
Mailing Address - Phone:619-507-1658
Mailing Address - Fax:
Practice Address - Street 1:5565 GROSSMONT CENTER DR
Practice Address - Street 2:BUILDING #1, SUITE 211
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3020
Practice Address - Country:US
Practice Address - Phone:619-507-1658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPENDING291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory