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General NPI Number Information
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NPI Number | 1528004066
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Entity Type | Organization
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Legal Business Name | JS MEDICAL
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8327 RESEDA BLVD
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City | NORTHRIDGE
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State | CA
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Zip | 91324-4620
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Country | US
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Telephone | 805-267-5114
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Fax |
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Provider Business Mailing Address
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Address Line | 1014 S WESTLAKE BLVD #14 BOX 114
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361-3108
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Country | US
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Telephone | 805-267-5114
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | SCOTT HARVEY
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Credential |
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Telephone | 805-267-5114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471C3402X
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Taxonomy Name | Radiography Radiologic Technologist
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License Number |
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License Number State |
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