Healthcare Provider Details

I. General information

NPI: 1811232358
Provider Name (Legal Business Name): ARIA NEURODIAGNOSTIC, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2012
Last Update Date: 12/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13746 VICTORY BLVD SUITE 107
VAN NUYS CA
91401-6716
US

IV. Provider business mailing address

13746 VICTORY BLVD SUITE 107
VAN NUYS CA
91401-6716
US

V. Phone/Fax

Practice location:
  • Phone: 818-203-8833
  • Fax:
Mailing address:
  • Phone: 818-203-8833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084D0003X
TaxonomyDiagnostic Neuroimaging (Psychiatry & Neurology) Physician
License NumberA101958
License Number StateCA

VIII. Authorized Official

Name: DR. EDWARD BARTON
Title or Position: DIRECTOR
Credential: MD
Phone: 818-203-8833