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General NPI Number Information
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NPI Number | 1245509819
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Entity Type | Organization
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Legal Business Name | IRVING NEURODIAGNOSTICS INC
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Dates
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Enumeration Date | 12/27/2011
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Last Update Date | 12/27/2011
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Provider Practice Location Address
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Address Line | 444 IRVING DR 101-A
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City | BURBANK
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State | CA
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Zip | 91504-2400
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Country | US
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Telephone | 818-955-8175
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Fax | 818-955-8935
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Provider Business Mailing Address
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Address Line | 444 IRVING DR 101A
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City | BURBANK
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State | CA
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Zip | 91504-2400
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Country | US
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Telephone | 818-955-8175
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Fax | 818-955-8935
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. ARTUR BAGHDISHYAN
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Credential |
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Telephone | 818-955-8175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number | A101958
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License Number State | CA
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