Healthcare Provider Details

I. General information

NPI: 1861649121
Provider Name (Legal Business Name): MEDICAL RESOURCE SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 08/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3760 MOTOR AVE SUITE 318
LOS ANGELES CA
90034-6404
US

IV. Provider business mailing address

PO BOX 341229
LOS ANGELES CA
90034-9229
US

V. Phone/Fax

Practice location:
  • Phone: 310-694-3750
  • Fax: 310-862-1881
Mailing address:
  • Phone: 310-694-3750
  • Fax: 310-862-1881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License NumberG35245
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2081N0008X
TaxonomyNeuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
License NumberA83354
License Number StateCA

VIII. Authorized Official

Name: DR. ANGELITA BALBAS
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 310-694-3750