Healthcare Provider Details

I. General information

NPI: 1316589765
Provider Name (Legal Business Name): SOMOS DIAGNOSTICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2019
Last Update Date: 10/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 EYE ST STE 207
BAKERSFIELD CA
93301-5208
US

IV. Provider business mailing address

127 S BRAND BLVD STE 303
GLENDALE CA
91204-1388
US

V. Phone/Fax

Practice location:
  • Phone: 661-241-0059
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State

VIII. Authorized Official

Name: HARUTYUN SARDARYAN
Title or Position: CEO
Credential:
Phone: 661-241-0059