Provider Demographics
NPI:1699323832
Name:CLINICAL INNOVATIONS, INC.
Entity type:Organization
Organization Name:CLINICAL INNOVATIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:POLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-533-5907
Mailing Address - Street 1:638 CAMINO DE LOS MARES STE H130-292
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-2848
Mailing Address - Country:US
Mailing Address - Phone:949-533-5907
Mailing Address - Fax:
Practice Address - Street 1:17800 WOODRUFF AVE STE B
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-7080
Practice Address - Country:US
Practice Address - Phone:562-748-4999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-30
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch