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General NPI Number Information
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NPI Number | 1316070501
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Entity Type | Organization
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Legal Business Name | MOBIL NEURODIAGNOSTICS SERVICES MANAGEMENT, INC
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11712 MOORPARK ST 110B
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City | STUDIO CITY
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State | CA
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Zip | 91604-2154
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Country | US
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Telephone | 818-958-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 11712 MOORPARK ST 110B
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City | STUDIO CITY
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State | CA
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Zip | 91604-2154
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Country | US
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Telephone | 818-958-9700
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SEMEN FOGEL
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Credential |
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Telephone | 818-958-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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