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General NPI Number Information
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NPI Number | 1629458765
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Entity Type | Organization
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Legal Business Name | AIDA K RECHDOUNI, MD INC
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Dates
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Enumeration Date | 06/04/2015
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Last Update Date | 03/23/2023
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Provider Practice Location Address
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Address Line | 2626 FOOTHILL BLVD STE 102
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City | LA CRESCENTA
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State | CA
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Zip | 91214-3574
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Country | US
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Telephone | 888-610-8909
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Fax | 888-610-8908
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Provider Business Mailing Address
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Address Line | 2750 PINERIDGE PL
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City | LA CRESCENTA
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State | CA
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Zip | 91214-1458
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Country | US
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Telephone | 818-468-2929
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Fax | 888-610-8908
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AIDA KAROUN RECHDOUNI
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Credential | M.D.
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Telephone | 818-468-2929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | CLF00342461
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | A72786
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License Number State | CA
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