Healthcare Provider Details
I. General information
NPI: 1376022012
Provider Name (Legal Business Name): PAYERSDIRECT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/13/2018
Last Update Date: 08/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11845 W OLYMPIC BLVD STE 1100W
LOS ANGELES CA
90064
US
IV. Provider business mailing address
PO BOX 491609
LOS ANGELES CA
90049-8609
US
V. Phone/Fax
- Phone: 310-954-9543
- Fax:
- Phone: 310-954-9543
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
RICHARD
TURKANIS
Title or Position: CEO
Credential: MD
Phone: 310-954-9543