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General NPI Number Information
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NPI Number | 1609955681
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Entity Type | Organization
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Legal Business Name | HEALTH DIAGNOSTIC CENTER
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3171 LOS FELIZ BLVD 212
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City | LOS ANGELES
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State | CA
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Zip | 90039-1527
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Country | US
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Telephone | 323-662-2970
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Fax | 323-662-2970
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Provider Business Mailing Address
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Address Line | 3171 LOS FELIZ BLVD 212
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City | LOS ANGELES
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State | CA
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Zip | 90039-1527
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Country | US
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Telephone | 323-662-2970
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Fax | 323-662-2970
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MR. GRACHIK HENRY KELOYAN
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Credential |
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Telephone | 323-662-2970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number | TG 427
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License Number State | CA
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