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General NPI Number Information
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NPI Number | 1225087976
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Entity Type | Organization
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Legal Business Name | SUPERSOUNG DIAGNOSTICS INC
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11755 VICTORY BLVD 240
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City | N HOLLYWOOD
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State | CA
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Zip | 91606-3423
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Country | US
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Telephone | 818-205-9666
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Fax |
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Provider Business Mailing Address
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Address Line | 11755 VICTORY BLVD 240
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City | N HOLLYWOOD
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State | CA
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Zip | 91606-3423
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Country | US
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Telephone | 818-205-9666
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NORAIR AVETISIAN
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Credential |
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Telephone | 818-205-9666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246XS1301X
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Taxonomy Name | Sonography Specialist/Technologist Cardiovascular
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License Number | 80971
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License Number State | CA
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