Provider Demographics
NPI:1982267001
Name:CALIFORNIA DIAGNOSTIC SPECIALISTS, INC.
Entity Type:Organization
Organization Name:CALIFORNIA DIAGNOSTIC SPECIALISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:TAN
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:626-678-3579
Mailing Address - Street 1:9191 WESTMINSTER AVE # 209
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92844-2751
Mailing Address - Country:US
Mailing Address - Phone:626-678-3579
Mailing Address - Fax:714-459-7047
Practice Address - Street 1:9191 WESTMINSTER AVE # 209
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-2751
Practice Address - Country:US
Practice Address - Phone:626-678-3579
Practice Address - Fax:714-459-7047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Multi-Specialty