Organization
ACTIVE DIAGNOSTICS OF NV LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY MONKS (BILLING SPECIALIST)
(530) 668-8988
Entity
Organization
Contact information
Practice address
216 F ST, #76, DAVIS, CA 95616-4515
(530) 668-8988
(530) 668-1229
Mailing address
216 F ST, #76, DAVIS, CA 95616
(530) 668-8988
(530) 668-1229
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A02500003857
HPN
NV
Enumeration date
12/05/2006
Last updated
08/22/2020
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