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General NPI Number Information
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NPI Number | 1265717938
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Entity Type | Organization
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Legal Business Name | BALANCE DREAM DIAGNOSTIC INC
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Dates
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Enumeration Date | 10/13/2011
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Last Update Date | 10/13/2011
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Provider Practice Location Address
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Address Line | 1915 W GLENOAKS BLVD 101A
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City | GLENDALE
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State | CA
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Zip | 91201-1541
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Country | US
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Telephone | 818-736-5511
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Fax |
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Provider Business Mailing Address
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Address Line | 1915 W GLENOAKS BLVD 101A
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City | GLENDALE
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State | CA
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Zip | 91201-1541
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Country | US
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Telephone | 818-736-5511
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALEXSANDER KARAPETYAN
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Credential |
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Telephone | 818-736-5511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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