NPIMap

Active Diagnostics, LLC

Organization Active NPI Electroneurodiagnostic Specialist/Technologist · Brentwood, TN

NPI 1720162514 · NPPES record last updated Jul 20, 2018

Key facts

NPI
1720162514
Entity type
Organization (NPI type 2)
Primary specialty
Electroneurodiagnostic Specialist/Technologist 246ZE0600X
Legal business name
ACTIVE DIAGNOSTICS, LLC
Practice address
3 Maryland Farms Ste 200
Brentwood, TN 37027-5005
Phone
(800) 348-4565
Fax
(615) 345-5405
NPI assigned
Oct 25, 2006
Organization subpart
No

Authorized official

Name
Mr. Jeffrey Gray
Title
Executive Vice President, Cfo and C
Phone
(800) 348-4565

National Provider Directory

Locations

6600 Bruceville Rd
Sacramento, CA 95823

66 Bovet Rd
Ste 101103
San Mateo, CA 94402
Phone (650) 570-0529

214 Centerview Dr
Ste 100
Brentwood, TN 37027
Phone (615) 345-5390

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Electroneurodiagnostic Specialist/Technologist
Group: 193400000X SINGLE SPECIALTY GROUP		 246ZE0600X Yes

Addresses

Primary practice location

3 Maryland Farms Ste 200
Brentwood, TN 37027-5005

Mailing address

3 Maryland Farms Ste 200
Brentwood, TN 37027-5005
Phone (800) 348-4565

Other identifiers

IdentifierTypeStateIssuer
ZZZ0521ZOtherCABLUE SHIELD

Other providers in Brentwood, TN

All providers in Brentwood, TN · Electroneurodiagnostic Specialist/Technologist in Tennessee

Sources for this page

Verify at the official NPI Registry.