Healthcare Provider Details

I. General information

NPI: 1174579932
Provider Name (Legal Business Name): SPIROMETRIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16200 VENTURA BLVD SUITE 412
ENCINO CA
91436-2205
US

IV. Provider business mailing address

16200 VENTURA BLVD SUITE 412
ENCINO CA
91436-2205
US

V. Phone/Fax

Practice location:
  • Phone: 818-981-4337
  • Fax: 818-981-4337
Mailing address:
  • Phone: 818-981-4337
  • Fax: 818-981-4337

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: LINA K BOLOTSKY
Title or Position: CEO
Credential:
Phone: 818-571-5702