Organization
DIAMOND DIAGNOSTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE FACTOR INDIVIDUAL (OWNER)
(480) 926-4363
Entity
Organization
Contact information
Practice address
1324 N FARRELL CT, SUITE 102, GILBERT, AZ 85233-1944
(480) 926-4363
Mailing address
1324 N FARRELL CT, SUITE 102, GILBERT, AZ 85233-1944
(480) 926-4363
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
174400000X
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z141818
PTAN
AZ
Enumeration date
09/09/2010
Last updated
02/22/2012
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