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General NPI Number Information
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NPI Number | 1063848844
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Entity Type | Organization
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Legal Business Name | AIRPORT URGENT CARE ENDOSCOPY CENTER
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Dates
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Enumeration Date | 09/24/2013
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Last Update Date | 10/02/2013
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Provider Practice Location Address
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Address Line | 1117 W MANCHESTER BLVD SUITE K
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City | INGLEWOOD
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State | CA
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Zip | 90301-1500
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Country | US
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Telephone | 310-403-7809
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Fax | 310-988-2669
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Provider Business Mailing Address
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Address Line | 1117 W MANCHESTER BLVD SUITE K
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City | INGLEWOOD
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State | CA
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Zip | 90301-1500
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Country | US
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Telephone | 310-403-7809
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Fax | 310-988-2669
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Authorized Official
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Title or Position | OWNER
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Name | JAMSHID SHARIATI
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Credential | MD
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Telephone | 310-403-7809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0800X
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Taxonomy Name | Endoscopy Clinic/Center
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License Number |
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License Number State |
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