Healthcare Provider Details

I. General information

NPI: 1386517969
Provider Name (Legal Business Name): LA FAST INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2025
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3255 CAHUENGA BLVD W STE 301
LOS ANGELES CA
90068-1778
US

IV. Provider business mailing address

3255 CAHUENGA BLVD W STE 301
LOS ANGELES CA
90068-1778
US

V. Phone/Fax

Practice location:
  • Phone: 213-947-9316
  • Fax:
Mailing address:
  • Phone: 213-947-9316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code292200000X
TaxonomyDental Laboratory
License Number
License Number State

VIII. Authorized Official

Name: NIZAM UDDIN
Title or Position: PRESIDENT
Credential:
Phone: 213-947-9316