Organization
DESERT DX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAXIMILIAN HUGH NCNALLY BSC (CEO)
(213) 999-0896
Entity
Organization
Contact information
Practice address
712 N ALTA VISTA BLVD, LOS ANGELES, CA 90046-7602
(213) 999-0896
Mailing address
157 OCEAN PARK BLVD, SANTA MONICA, CA 90405-3525
(213) 999-0896
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
11/29/2020
Last updated
11/29/2020
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