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General NPI Number Information
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NPI Number | 1689327603
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Entity Type | Organization
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Legal Business Name | NU WAVE NDT INC
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Dates
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Enumeration Date | 01/31/2022
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Last Update Date | 01/31/2022
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Provider Practice Location Address
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Address Line | 1720 E. CESAR CHAVEZ AVENUE
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City | LOS ANGELES
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State | CA
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Zip | 90033
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Country | US
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Telephone | 323-268-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1108 N ANGELENO AVE # 911
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City | AZUSA
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State | CA
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Zip | 91702-1913
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Country | US
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Telephone | 626-224-1287
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Fax |
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Authorized Official
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Title or Position | INTRAOPERATIVENEUROMONITORIST
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Name | MS. ROCIO BAENA
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Credential | R. EEG., CNIM, BS
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Telephone | 626-224-1287
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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