Healthcare Provider Details

I. General information

NPI: 1861622490
Provider Name (Legal Business Name): RADIANCE HEALTH GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2009
Last Update Date: 09/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11860 WILSHIRE BLVD STE 100
LOS ANGELES CA
90025-6613
US

IV. Provider business mailing address

11860 WILSHIRE BLVD STE 100
LOS ANGELES CA
90025-6613
US

V. Phone/Fax

Practice location:
  • Phone: 310-312-1111
  • Fax: 310-312-1139
Mailing address:
  • Phone: 310-312-1111
  • Fax: 310-312-1139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberA26327
License Number StateCA

VIII. Authorized Official

Name: DR. NORMAN NARCHI
Title or Position: PRESIDENT
Credential: MD
Phone: 310-312-1111