Provider Demographics
NPI:1285994764
Name:DINEURO DIAGNOSTIC
Entity type:Organization
Organization Name:DINEURO DIAGNOSTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SIROUS
Authorized Official - Middle Name:
Authorized Official - Last Name:SORAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-554-2222
Mailing Address - Street 1:13896 HARBOR BLVD
Mailing Address - Street 2:SUITE 5C
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:93843
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13896 HARBOR BLVD
Practice Address - Street 2:SUITE 5C
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4045
Practice Address - Country:US
Practice Address - Phone:714-554-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory