Organization
SPINE & NERVE DIAGNOSTIC CENTER
Active
Parent organization
SPINE & NERVE DIAGNOSTIC CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPINE & NERVE DIAGNOSTIC CENTER
Authorized official
VINAY MOOLA REDDY (PRESIDENT AND CEO)
(916) 772-5325
Entity
Organization
Contact information
Practice address
4200 DOUGLAS BLVD, GRANITE BAY, CA 95746-5902
(916) 722-5325
Mailing address
1528 EUREKA RD STE 103, ROSEVILLE, CA 95661-3047
(916) 772-5325
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
11/07/2019
Last updated
11/07/2019
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