Healthcare Provider Details

I. General information

NPI: 1477585602
Provider Name (Legal Business Name): SPECTRUM DIAGNOSTIC SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

1127 WILSHIRE BLVD STE 1507
LOS ANGELES CA
90017-4006
US

IV. Provider business mailing address

1127 WILSHIRE BLVD STE 1507
LOS ANGELES CA
90017-4006
US

V. Phone/Fax

Practice location:
  • Phone: 213-977-1399
  • Fax:
Mailing address:
  • Phone: 213-977-1399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. GEVORG ASLANIAN
Title or Position: CEO
Credential:
Phone: 213-977-1399