Organization
PACIFIC DIAGNOSTIC MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DWAYE KEVIN POWELL (OWNER)
(818) 353-1774
Entity
Organization
Contact information
Practice address
9454 CORDERO AVE, TUJUNGA, CA 91042-3302
(818) 353-1774
Mailing address
9454 CORDERO AVE, TUJUNGA, CA 91042-3302
(818) 353-1774
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Enumeration date
02/15/2006
Last updated
08/22/2020
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