# INITIAL INNOVATIVE BLOOD, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Initial Innovative Blood, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437736295
- **Authorized official:** MR. ALFRED SAMUEL (CEO)
- **Authorized official phone:** (714) 209-9009

## Contact information

- **Practice address:** 16481 WATERWAY CIR APT B, HUNTINGTON BEACH, CA 92649-3256
- **Practice address phone:** (714) 209-9009
- **Practice address fax:** (714) 384-7233
- **Mailing address:** 16481 WATERWAY CIR APT B, HUNTINGTON BEACH, CA 92649-3256
- **Mailing address phone:** (714) 209-9009
- **Mailing address fax:** (714) 384-7233

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 156F00000X | Technician/Technologist | — | NULL | Yes |
| 156F00000X | Technician/Technologist | — | — | Yes |

## Other

- **Enumeration date:** 03/26/2021
- **Last updated:** 03/26/2021