Provider Demographics
NPI:1902328115
Name:PULMONARY FUNCTION TESTING & DIAGNOSTICS
Entity Type:Organization
Organization Name:PULMONARY FUNCTION TESTING & DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:CLEVENGER
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:949-444-6917
Mailing Address - Street 1:27821 BARBATE
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-1230
Mailing Address - Country:US
Mailing Address - Phone:949-444-6917
Mailing Address - Fax:949-421-3196
Practice Address - Street 1:27821 BARBATE
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-1230
Practice Address - Country:US
Practice Address - Phone:949-444-6917
Practice Address - Fax:949-421-3196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA227292279P1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2279P1006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary Function TechnologistGroup - Single Specialty