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General NPI Number Information
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NPI Number | 1679960058
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Entity Type | Organization
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Legal Business Name | A & T NEUROLOGICAL CENTER, INC
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Dates
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Enumeration Date | 04/23/2015
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Last Update Date | 04/23/2015
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Provider Practice Location Address
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Address Line | 15130 VENTURA BLVD SUITE # 305
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-3301
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Country | US
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Telephone | 818-849-5407
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Fax | 818-849-5802
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Provider Business Mailing Address
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Address Line | 15130 VENTURA BLVD., SUITE # 305
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-3378
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Country | US
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Telephone | 818-849-5407
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Fax | 818-849-5802
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GEVORK MKHITARYAN
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Credential |
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Telephone | 818-849-5407
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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 | C3765212
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License Number State | CA
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