Provider Demographics
NPI:1588967939
Name:HAEMOKINETICS LLC
Entity type:Organization
Organization Name:HAEMOKINETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:CERT PERFUSIONIST
Authorized Official - Phone:714-269-4066
Mailing Address - Street 1:1981 SCENIC RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-1004
Mailing Address - Country:US
Mailing Address - Phone:714-269-4066
Mailing Address - Fax:909-591-8343
Practice Address - Street 1:1981 SCENIC RIDGE DR
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-1004
Practice Address - Country:US
Practice Address - Phone:714-269-4066
Practice Address - Fax:909-591-8343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE242T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionistGroup - Multi-Specialty