Provider Demographics
NPI:1952765182
Name:ZEUS DIAGNOSTICS MEDICAL GROUP INC
Entity type:Organization
Organization Name:ZEUS DIAGNOSTICS MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUBBARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-505-2093
Mailing Address - Street 1:P.O. BOX 6646
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CALIFORNIA
Mailing Address - Zip Code:92863
Mailing Address - Country:UM
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17821 17TH ST
Practice Address - Street 2:STE #250
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-2136
Practice Address - Country:US
Practice Address - Phone:714-505-2093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-13
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG37235174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty