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General NPI Number Information
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NPI Number | 1043986441
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Entity Type | Organization
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Legal Business Name | IV PROS INC
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Dates
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Enumeration Date | 08/17/2021
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Last Update Date | 08/17/2021
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Provider Practice Location Address
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Address Line | 261 W ALAMEDA AVE
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City | BURBANK
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State | CA
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Zip | 91502-2559
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Country | US
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Telephone | 888-844-8114
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Fax | 888-664-0395
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Provider Business Mailing Address
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Address Line | 261 W ALAMEDA AVE
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City | BURBANK
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State | CA
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Zip | 91502-2559
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Country | US
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Telephone | 888-844-8114
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Fax | 888-664-0395
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. KRISTINE DANA HAYRAP
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Credential |
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Telephone | 818-903-8244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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