Organization
SUN DIAGNOSTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELEONORA KIRNOS (OWNER)
(323) 934-9873
Entity
Organization
Contact information
Practice address
425 S FAIRFAX AVE, SUITE 308, LOS ANGELES, CA 90036-3148
(323) 934-9873
Mailing address
425 S FAIRFAX AVE, SUITE 308, LOS ANGELES, CA 90036-3148
(323) 934-9873
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TG070
MEDICARE PROVIDER NUMBER
CA
Enumeration date
08/16/2006
Last updated
08/22/2020
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