Med-Source Diagnostics

Primary specialty

Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X

License

BUS02/02209 Issued in CA

Legal business name

MED-SOURCE DIAGNOSTICS

Practice address

92 Corporate Park
Suite C226
Irvine, CA 92606-5146

Phone

(959) 955-1398

Fax

(949) 861-7130

NPI assigned

Mar 10, 2009

Organization subpart

No

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

Authorized official

Name

Yvette Ceja

Title

Executive Director

Phone

(949) 955-1398

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1236643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236643200000",
    "number": "1982845640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 CORPORATE PARK",
            "address_2": "SUITE C226",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926065146",
            "telephone_number": "959-955-1398",
            "fax_number": "949-861-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 CORPORATE PARK",
            "address_2": "SUITE C226",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926065146",
            "telephone_number": "959-955-1398",
            "fax_number": "949-861-7130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED-SOURCE DIAGNOSTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-10",
        "last_updated": "2009-03-10",
        "status": "A",
        "authorized_official_last_name": "CEJA",
        "authorized_official_first_name": "YVETTE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "949-955-1398"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": "CA",
            "license": "BUS02/02209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medcare Transportation Corp
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• Medhealth Medical LLC
• Media Najafi DDS Inc
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• Electroneurodiagnostic Specialist/Technologist in Irvine, CA
• Providers in Irvine, CA by specialty
• Electroneurodiagnostic Specialist/Technologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2009; 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.