Healthcare Provider Details

I. General information

NPI: 1952225443
Provider Name (Legal Business Name): EEG CORE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10523 BURBANK BLVD STE 105
NORTH HOLLYWOOD CA
91601-2235
US

IV. Provider business mailing address

10523 BURBANK BLVD STE 105
NORTH HOLLYWOOD CA
91601-2235
US

V. Phone/Fax

Practice location:
  • Phone: 818-824-3022
  • Fax: 818-824-3145
Mailing address:
  • Phone: 818-824-3022
  • Fax: 818-824-3145

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: KAIRAT BAKYTBEKOVICH
Title or Position: CEO OWNER
Credential:
Phone: 818-824-3022