Healthcare Provider Details

I. General information

NPI: 1215152459
Provider Name (Legal Business Name): SOUTHWESTERN NEURODIAGNOSTIC CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1545 N VERDUGO RD 110
GLENDALE CA
91208-2841
US

IV. Provider business mailing address

1229 E WILSON AVE 304
GLENDALE CA
91206-4641
US

V. Phone/Fax

Practice location:
  • Phone: 818-550-8628
  • Fax:
Mailing address:
  • Phone: 818-731-8922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2472E0500X
TaxonomyEEG Technician
License Number
License Number State

VIII. Authorized Official

Name: ANNA INKERI SOMERTO
Title or Position: OWNER PRESIDENT
Credential: M.D.
Phone: 818-731-8922