Provider Demographics
NPI:1437820933
Name:CDG BIOTECH CORPORATION
Entity type:Organization
Organization Name:CDG BIOTECH CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NOEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SILVA DOMNIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MSC
Authorized Official - Phone:805-222-0877
Mailing Address - Street 1:31332 VIA COLINAS STE 106
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-6776
Mailing Address - Country:US
Mailing Address - Phone:805-222-0877
Mailing Address - Fax:
Practice Address - Street 1:31332 VIA COLINAS STE 106
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-6776
Practice Address - Country:US
Practice Address - Phone:805-222-0877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory