Provider Demographics
NPI:1790386746
Name:MVML, INC.
Entity type:Organization
Organization Name:MVML, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:AZARRAGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-215-2811
Mailing Address - Street 1:300 SPECTRUM CENTER DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-4987
Mailing Address - Country:US
Mailing Address - Phone:951-658-1400
Mailing Address - Fax:
Practice Address - Street 1:1594 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-3443
Practice Address - Country:US
Practice Address - Phone:714-974-2020
Practice Address - Fax:714-279-2020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-05
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACDF-900001870OtherDEPT. OF HEALTH SERV
PA40965OtherPA DEPT. OF HEALTH
MD3907OtherMARYLAND DEPT. OF HEALTH
RILCO01741OtherDEPT. OF HEALTH - CENTER FOR HEALTH FACILITIES REGULATION