Basic Information
| Provider Information | |||||||||
| NPI: | 1457382400 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEALTH DIAGNOSTICS OF CALIFORNIA LLC | ||||||||
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| OtherOrganizationName: | BMC DIAGNOSTICS INC | ||||||||
| OtherOrganizationType: | 4 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1201 MARINA VILLAGE PKWY | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | ALAMEDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945011087 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5108659670 | ||||||||
| FaxNumber: | 5108659680 | ||||||||
| Practice Location | |||||||||
| Address1: | 625 LINCOLN AVE | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951263705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5108659670 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2006 | ||||||||
| LastUpdateDate: | 10/15/2008 | ||||||||
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| AuthorizedOfficialLastName: | CHACKERIAN | ||||||||
| AuthorizedOfficialFirstName: | ARA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 5108659670 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | HEALTH DIAGNOSTICS LLC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0208X | 42393 | CA | Y | Ambulatory Health Care Facilities | Clinic/Center | Radiology, Mobile |
No ID Information.