Healthcare Provider Details

I. General information

NPI: 1316551229
Provider Name (Legal Business Name): PATEX LABS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

6450 BELLINGHAM AVE STE D
NORTH HOLLYWOOD CA
91606-1401
US

IV. Provider business mailing address

6450 BELLINGHAM AVE STE D
NORTH HOLLYWOOD CA
91606-1401
US

V. Phone/Fax

Practice location:
  • Phone: 818-743-4443
  • Fax:
Mailing address:
  • Phone: 818-743-4443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: GEVORG STEPANYAN
Title or Position: CEO
Credential:
Phone: 818-743-4443