Healthcare Provider Details

I. General information

NPI: 1871920652
Provider Name (Legal Business Name): BADR MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2013
Last Update Date: 11/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E CHEVY CHASE DR STE 204
GLENDALE CA
91206-4152
US

IV. Provider business mailing address

PO BOX 41926
LOS ANGELES CA
90041-0926
US

V. Phone/Fax

Practice location:
  • Phone: 818-827-3898
  • Fax: 818-827-3897
Mailing address:
  • Phone: 818-562-6400
  • Fax: 848-562-6405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: YASER BADR
Title or Position: PRESIDENT
Credential: M.D.
Phone: 818-827-3898