INDEPENDENT DIAGNOSTIC TESTING INC (NPI# 1124342373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1124342373 |
Entity Type | Organization |
Organization Name | INDEPENDENT DIAGNOSTIC TESTING INC |
Practice Address |
7877 Parkway Dr La Mesa CA 91942-2000 |
Practice Telephone | 6194610039 |
Practice Fax Number | 6194615941 |
Mailing Telephone | 6194610039 |
Mailing Fax Number | 6194615941 |
Enumeration Date | 2010-03-17 |
Last Update Date | 2010-03-17 |
Authorized Official Name | MR. FRED E SUFFICOOL (CEO) |
Authorized Official Telephone | 6194610039 |
Authorized Official Credential | PARAMEDIC |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 335V00000X | CA | Suppliers |
Street Address |
7877 PARKWAY DR |
City | LA MESA |
State | CA |
Zip Code | 91942-2000 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366448243 | Paul L Treger Md A Medical Corporation | Ophthalmology | 7877 Parkway Dr, Ste 100, La Mesa, CA 91942-2000 | 2005-06-24 |
1720359789 | Sarah E Stanton Md Inc | Clinic/Center | 7877 Parkway Dr, Siute B, La Mesa, CA 91942-2000 | 2012-01-23 |
1891933941 | Aireen L. Gutierrez, M.d., Inc. | Internal Medicine | 7877 Parkway Dr, Suite 1b, La Mesa, CA 91942-2000 | 2009-01-28 |
1578748018 | Mobile Physician Services | Clinical Medical Laboratory | 7877 Parkway Dr, Suite 1b, La Mesa, CA 91942-2000 | 2008-01-03 |
1184748311 | Martin M Nosan | Internal Medicine | 7877 Parkway Dr, Suite 1b, La Mesa, CA 91942-2000 | 2007-03-16 |
1447311899 | Paul Leslie Treger | Ophthalmology | 7877 Parkway Dr, Suite 100, La Mesa, CA 91942-2000 | 2006-12-12 |
1013078427 | Glenn Cook | Ophthalmology | 7877 Parkway Dr, Suite 100, La Mesa, CA 91942-2000 | 2006-12-12 |
1609963974 | Anthony Trong Tran | Dentist | 7877 Parkway Dr, Suite 2b, La Mesa, CA 91942-2000 | 2006-10-06 |
1255436804 | Mark Shaffer | Internal Medicine | 7877 Parkway Dr, Suite1b, La Mesa, CA 91942-2000 | 2006-09-14 |
1316939978 | William Burton Davis | Internal Medicine | 7877 Parkway Dr, Suite 1b, La Mesa, CA 91942-2000 | 2005-08-19 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902453723 | Nicole V Zappelli | Case Manager/Care Coordinator | 4990 William Ave., La Mesa, CA 91942 | 2019-08-26 |
1770059834 | Natalie Ngoc Nguyen | Physician Assistant | 5555 Grosmont Center Dr., La Mesa, CA 91942 | 2018-10-16 |
1194204297 | Courtney Pietsch | Nurse Practitioner | 8851 Health Center Circle, Suite #603, La Mesa, CA 91942 | 2018-08-09 |
1295214773 | Megan Gordon | Behavior Technician | 6116 Horton Dr, La Mesa, CA 91942 | 2018-08-07 |
1356836548 | Kimberly Denise Davis | Counselor | 3845 Avocado School Road, El Cajon, CA 91942 | 2018-06-29 |
1366932113 | Melanie Joyce Shepard | Physician Assistant | 7051 Alvarado Road, Suite 201, La Mesa, CA 91942 | 2018-05-17 |
1871013532 | Low Dental, A.p.c. | Public Health or Welfare | 7872 La Mesa Blvd., La Mesa, CA 91942 | 2017-06-23 |
1275069437 | Ardel Ayala | Respiratory Therapist, Registered | 5800 Lake Murray Blvd. Unit 15, La Mesa, CA 91942 | 2017-05-10 |
1285007583 | Counseling & Behavioral Specialists | Marriage & Family Therapist | 5520 Wellesley Street, Ste 204, La Mesa, CA 91942 | 2015-11-09 |
1285001875 | Emily Shozaki Rizo | Nurse Practitioner | 6285 Meadowcrest Drive, La Mesa, CA 91942 | 2015-08-31 |
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Taxonomy Code | 335V00000X |
Grouping | Suppliers |
Classification | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
A supplier that provides one or more of the following portable services, including but not limited to, x-ray, electrocardiogram (EKG), long-term EKG (Holter Monitor), bone densitometry, sonography, and other imaging services in accordance with all state and federal requirements, under the general supervision of a qualified physician. All necessary resources are transported to the patient's location where the services are performed. |
Notes: Source: National Uniform Claim Committee, 2015 [1/1/2016: title and definition modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417146903 | Sd Xray LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 8900 Grossmont Blvd Ste 1, La Mesa, CA 91941-4047 | 2007-10-19 |
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1114583549 | Ruahrena Corporation | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 3053 West Olympic Boulevard, Suite 301, Los Angeles, CA 90006 | 2019-05-10 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.