Provider Demographics
NPI:1174932701
Name:HEALTH DIAGNOSTICS OF CALIFORNIA, LLC
Entity type:Organization
Organization Name:HEALTH DIAGNOSTICS OF CALIFORNIA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
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:888-685-3909
Mailing Address - Fax:800-508-4751
Practice Address - Street 1:665 MUNRAS AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-3134
Practice Address - Country:US
Practice Address - Phone:831-656-9800
Practice Address - Fax:831-656-9801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-07
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology