NPI 1669520268

Surgical Specialty Imaging LLC

Organisation Physiological Laboratory Phoenix, AZ

Practice location

Address: 6501 N 19th Ave STE a, Phoenix, AZ 85015-1646
Phone: (602) 314-4280
Fax: (602) 314-4289
Mailing address: 26250 Enterprise CT STE 100, Lake Forest, CA 92630-8406

Authorised official

Name: Brian G. Drazba
Title: Senior V.P. & Chief Accounting Ofcr
Phone: (949) 282-6000

Registered specialties

Physiological Laboratory Primary

Laboratories Taxonomy 293D00000X

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Registry record

NPI: 1669520268
Entity type: Organization
NPI issued: 8 Jan 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.