Healthcare Provider Details

I. General information

NPI: 1811368178
Provider Name (Legal Business Name): REM NEURODIAGNOSTICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2015
Last Update Date: 10/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4214 GREEN RIVER RD SUITE NUMBER 200
CORONA CA
92880-1669
US

IV. Provider business mailing address

7 MUSICK
IRVINE CA
92618-1638
US

V. Phone/Fax

Practice location:
  • Phone: 877-874-6336
  • Fax: 877-874-6335
Mailing address:
  • Phone: 877-874-6336
  • Fax: 877-874-6335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: FARSHAD FIROUZNAM
Title or Position: PRESIDENT
Credential:
Phone: 877-874-6336