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General NPI Number Information
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NPI Number | 1174190565
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Entity Type | Organization
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Legal Business Name | NUFAZE NETWORKING SOLUTIONS
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Dates
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Enumeration Date | 06/05/2021
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Last Update Date | 11/01/2022
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Provider Practice Location Address
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Address Line | 5250 SANTA MONICA BLVD STE 213
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City | LOS ANGELES
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State | CA
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Zip | 90029-1254
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Country | US
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Telephone | 323-570-0270
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Fax | 323-952-5184
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Provider Business Mailing Address
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Address Line | 5250 SANTA MONICA BLVD STE 213
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City | LOS ANGELES
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State | CA
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Zip | 90029-1254
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Country | US
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Telephone | 323-570-0270
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Fax | 323-952-5184
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Authorized Official
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Title or Position | PRESIDENT
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Name | EVA S GOMEZ
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Credential |
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Telephone | 323-570-0270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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