Provider Demographics
NPI:1104905629
Name:PULMONARY DISEASE SERVICES
Entity type:Organization
Organization Name:PULMONARY DISEASE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:714-896-7382
Mailing Address - Street 1:14301 MARINER LN
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-4573
Mailing Address - Country:US
Mailing Address - Phone:714-896-7382
Mailing Address - Fax:714-896-7316
Practice Address - Street 1:14120 BEACH BLVD STE 104
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-4454
Practice Address - Country:US
Practice Address - Phone:714-896-7382
Practice Address - Fax:714-896-7316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA546892261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health