Organization
MED-SOURCE DIAGNOSTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YVETTE CEJA (EXECUTIVE DIRECTOR)
(949) 955-1398
Entity
Organization
Contact information
Practice address
92 CORPORATE PARK, SUITE C226, IRVINE, CA 92606-5146
(959) 955-1398
(949) 861-7130
Mailing address
92 CORPORATE PARK, SUITE C226, IRVINE, CA 92606-5146
(959) 955-1398
(949) 861-7130
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
BUS02/02209
CA
Other
Enumeration date
03/10/2009
Last updated
03/10/2009
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