MEDICARE: GLOBAL NEURODIAGNOSTIC SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0208X	Mobile Radiology Clinic/Center

General Provider Information

NPI Number	:	1841393287
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLOBAL NEURODIAGNOSTIC SERVICES

Provider Business Mailing Address
First Line	:	815 E COLORADO ST
Second Line	:	# 220
City	:	GLENDALE
State	:	CA
Zip	:	91205-1200
Country	:	US
Telephone Number	:	818-956-0500
Fax Number	:	818-956-8489

Provider Business Practice Location Address
First Line	:	815 E COLORADO ST STE 220
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-4508
Country	:	US
Telephone Number	:	818-956-0500
Fax Number	:	818-956-8489

Authorized Official
Title or Position	:	OWNER
Name	:	SONA BALASANYAN
Credential	:
Telephone Number	:	818-956-0500

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	07/21/2022

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