Ghost Line Labs,Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

G82171 Issued in CA

Legal business name

GHOST LINE LABS,INC.

Practice address

137 Masters Circle
Costa Mesa, CA 92627

Phone

(619) 481-9632

NPI assigned

Mar 27, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Suzie E Schuder, M.D.

Title

Director of Lab

Phone

(949) 722-9884

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1801162508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 TRUXTUN AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933014820",
            "telephone_number": "619-481-9632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 MASTERS CIRCLE",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "92627",
            "telephone_number": "619-481-9632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GHOST LINE LABS,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-27",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "SCHUDER",
        "authorized_official_first_name": "SUZIE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR OF LAB",
        "authorized_official_telephone_number": "949-722-9884",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "G82171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reza Ghaboosi
• Sara Ghannadi, PA-C
• Subhash Ramchandra Gharmalkar, N.D.,L.AC.
• Maryrose Ghassan
• Elmira Ghatrehsamani, DC
• Stephanie Giammichele, LMFT
• Sophantreia Sara Giannamore
• Marc V. Gianzero, M.D.
• Krista Gibert
• Robin Giesen, MA

• Clinical Medical Laboratory in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.