| Organization Name: | REVEAL DIAGNOSTICS, LLC |
| NPI Number: | 1487902821 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARSHALL BRICKEEN (OWNER) |
| Mailing Address: | 100 W El Camino Real Suite 63b Mountain View |
| State: | CA US |
| Postal Code: | 940402664 |
| Phone Number: | 8889738325 |
| Fax Number: | 4153589633 |
| NPI Enumeration Date: | 08/15/2012 |
| NPI Last Update Date: | 08/15/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |