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General NPI Number Information
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NPI Number | 1558669093
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Entity Type | Organization
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Legal Business Name | ACCUSCAN DIAGNOSTIC SERVICES
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Dates
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Enumeration Date | 03/08/2011
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Last Update Date | 03/08/2011
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Provider Practice Location Address
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Address Line | 14621 TITUS ST SUITE 131
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City | VAN NUYS
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State | CA
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Zip | 91402-4905
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Country | US
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Telephone | 818-908-5925
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Fax | 818-908-5925
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Provider Business Mailing Address
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Address Line | 14621 TITUS ST SUITE 131
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City | VAN NUYS
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State | CA
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Zip | 91402-4905
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Country | US
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Telephone | 818-908-5925
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Fax | 818-908-5925
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ZORAYDA GAUZON
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Credential |
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Telephone | 818-647-2103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number | 002542091-0001-2
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License Number State | CA
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