Professional Diagnostics Management

Specialty details in registry · Roseville, CA

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At a glance

2241 Lava Ridge Ct, Roseville, CA 95661-3034

NPPES record updated Aug 22, 2020. Public records can lag behind changes at a practice.

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Practice location

2241 Lava Ridge Ct
Roseville, CA 95661-3034
Professional details: NPI, taxonomy & registry record
NPI1790827780
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
305R00000X
Enumeration date
Feb 13, 2007
Record updated
Aug 22, 2020
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

305R00000X · Primary

License reported: 014442 CA

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

2241 Lava Ridge Ct
Roseville, CA 95661-3034
Phone
(916) 782-2200
Mailing address
2241 LAVA RIDGE CT

ROSEVILLE, CA 956613034
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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