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General NPI Number Information
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NPI Number | 1679948905
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Entity Type | Organization
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Legal Business Name | PROMED GROUP SERVICES
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Dates
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Enumeration Date | 12/11/2015
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Last Update Date | 12/11/2015
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Provider Practice Location Address
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Address Line | 8780 VAN NUYS BLVD
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City | PANORAMA CITY
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State | CA
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Zip | 91402-2412
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Country | US
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Telephone | 818-894-3111
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Fax | 818-894-3133
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Provider Business Mailing Address
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Address Line | 8950 W OLYMPIC BLVD
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-3561
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Country | US
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Telephone | 818-894-3111
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Fax | 818-894-3133
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Authorized Official
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Title or Position | SECRETARY/TREASURER
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Name | NADER ARMANIOUS
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Credential | M.D.
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Telephone | 818-894-3111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A72795
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License Number State | CA
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