Pacific Diagnostics in Villa Park - Family Medicine
Pacific Diagnostics - NPI 1306881297
Pacific Diagnostics is a Family Medicine in Villa Park, California. Pacific Diagnostics practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Pacific Diagnostics is 1306881297. The last update date is 2020-08-22.
Pacific Diagnostics's current location address is 17853 Santiago Blvd, Villa Park, California. You can contact this provider via phone number 7147410622 and fax number 7147410623. The mailing address for Pacific Diagnostics is 17853 Santiago Blvd, Villa Park, California. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Pacific Diagnostics |
|---|---|
| Address | 17853 Santiago Blvd, Villa Park, California |
| Phone Number | 7147410622 |
| Fax Number | 7147410623 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT/ |
|---|---|
| Authorized Official Name | Henderson Jarald Bryn |
| Credentials | D.O. |
| Telephone Number | 7147410622 |
NPI Number Detail
| NPI Number | 1306881297 |
|---|---|
| Provider Enumeration Date | 2006-06-17 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 17853 Santiago Blvd |
|---|---|
| City | Villa Park |
| State | California (CA) |
| Post Code | 928614113 |
| Phone Number | 7147410622 |
| Fax Number | 7147410623 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | 20A4401 |
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Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 00AX44011 | CA | -- | |
| 00AX44010 | CA | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Pacific Diagnostics?
The Pacific Diagnostics has been issued the NPI (National Provider Identifier) 1306881297 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete street address where Pacific Diagnostics is physically located?
The Pacific Diagnostics is physically situated at the following address: 17853 Santiago Blvd, Villa Park, CA, 928614113.
What is Pacific Diagnostics's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Pacific Diagnostics is Family Medicine, and the taxonomy code that categorizes this field of expertise is 207Q00000X.
On what date did Pacific Diagnostics receive its 1306881297 assignment from the Centers for Medicare & Medicaid Services?
The Pacific Diagnostics was assigned its 1306881297 on 2006-06-17, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the Pacific Diagnostics's information last updated?
The Pacific Diagnostics's information was last updated on 2020-08-22.