| Organization Name: | MINUTECLINIC DIAGNOSTIC MEDICAL GROUP OF CALIFORNIA, INC. |
| NPI Number: | 1033309372 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEBORAH PINCINCE (RC MANAGER) |
| Mailing Address: | 19353 Victory Blvd Tarzana |
| State: | CA US |
| Postal Code: | 913356302 |
| Phone Number: | 8663892727 |
| Fax Number: | 4014063539 |
| NPI Enumeration Date: | 08/01/2007 |
| NPI Last Update Date: | 06/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |