Provider Demographics
NPI:1801604624
Name:DIAGU INC
Entity type:Organization
Organization Name:DIAGU INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP CORPORATE DEVELOPMENT & OPNS.
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:FASI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-801-0336
Mailing Address - Street 1:10803 THORNMINT RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-2406
Mailing Address - Country:US
Mailing Address - Phone:619-798-6311
Mailing Address - Fax:
Practice Address - Street 1:10803 THORNMINT RD STE 200
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-2406
Practice Address - Country:US
Practice Address - Phone:619-798-6311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-26
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory