Organization
NANJOBE TOX LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWIN SAMUEL KULUBYA M.D. (MD)
(714) 701-1071
Entity
Organization
Contact information
Practice address
5475 E LA PALMA AVE STE 205, ANAHEIM, CA 92807-2075
(714) 701-1071
(714) 701-1078
Mailing address
5475 E LA PALMA AVE STE 205, ANAHEIM, CA 92807-2075
(714) 701-1071
(714) 701-1078
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
G54189
CA
Other
Enumeration date
07/21/2015
Last updated
07/21/2015
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