Provider Demographics
NPI:1982966172
Name:HEALTH DIAGNOSTICS OF CALIFORNIA LLC
Entity Type:Organization
Organization Name:HEALTH DIAGNOSTICS OF CALIFORNIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-264-2400
Mailing Address - Street 1:PO BOX 203557
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-3557
Mailing Address - Country:US
Mailing Address - Phone:888-685-3910
Mailing Address - Fax:800-508-4751
Practice Address - Street 1:14651 S BASCOM AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2014
Practice Address - Country:US
Practice Address - Phone:408-356-9013
Practice Address - Fax:408-356-9014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-13
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty