Healthcare Provider Details

I. General information

NPI: 1952334310
Provider Name (Legal Business Name): EASY MANAGEMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11860 WILSHIRE BLVD 100
LOS ANGELES CA
90025-6613
US

IV. Provider business mailing address

11860 WILSHIRE BLVD 100
LOS ANGELES CA
90025-6613
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: IGOR PETROVSKY
Title or Position: PRESIDENT
Credential:
Phone: 310-312-1111