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Organization
PERSONAL SPACE TESTING EAST
Active
Organization
PERSONAL SPACE TESTING EAST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUSTIN L YOUNG (CEO)
(310) 999-9824
Entity
Organization
Contact information
Practice address
99 WALL ST STE 3350, NEW YORK, NY 10005-4301
(310) 999-9824
Mailing address
1212 STANFORD AVE STE 106, LOS ANGELES, CA 90021-2157
(310) 999-9824
(310) 861-1599
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
261Q00000X
Clinic/Center
—
NULL
261QC1500X
Community Health Clinic/Center
—
NULL
261QH0100X
Health Service Clinic/Center
—
NULL
Other
Enumeration date
02/01/2022
Last updated
02/01/2022
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