Healthcare Provider Details

I. General information

NPI: 1487185625
Provider Name (Legal Business Name): MEDICAL PRO HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2017
Last Update Date: 03/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 W BURBANK BLVD 300
BURBANK CA
91505-2347
US

IV. Provider business mailing address

1812 W BURBANK BLVD 81
BURBANK CA
91506
US

V. Phone/Fax

Practice location:
  • Phone: 818-568-0006
  • Fax: 888-730-7347
Mailing address:
  • Phone: 818-568-0006
  • Fax: 888-730-7347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. ALFRED LEVONIANS
Title or Position: PRESIDENT
Credential:
Phone: 818-568-0006