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Organization

PERSONAL SPACE TESTING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AUSTIN L YOUNG PARAMEDIC (FIELD OPERATIONS EXECUTIVE)
(310) 999-9824
Entity
Organization

Contact information

Practice address
25657 PINE CREEK LN, WILMINGTON, CA 90744-1823
(310) 999-9824
Mailing address
PO BOX 437, HARBOR CITY, CA 90710-0437
(310) 999-9824

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
251E00000X
Home Health Agency
251K00000X
Public Health or Welfare Agency
Primary
251S00000X
Community/Behavioral Health Agency
253Z00000X
In Home Supportive Care Agency
261QC1500X
Community Health Clinic/Center
261QC1800X
Corporate Health Clinic/Center
261QP0905X
State or Local Public Health Clinic/Center
261QX0100X
Occupational Medicine Clinic/Center
291U00000X
Clinical Medical Laboratory

Other

Enumeration date
01/17/2021
Last updated
01/17/2021
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