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General NPI Number Information
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NPI Number | 1730419607
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Entity Type | Organization
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Legal Business Name | CYTOLOGY ASSOCIATES OF HOUSTON
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Dates
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Enumeration Date | 12/28/2009
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Last Update Date | 12/28/2009
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Provider Practice Location Address
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Address Line | 1611 N SAN FERNANDO BLVD STE B
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City | BURBANK
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State | CA
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Zip | 91504-4152
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Country | US
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Telephone | 818-206-7236
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Fax |
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Provider Business Mailing Address
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Address Line | 1611 N SAN FERNANDO BLVD STE B
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City | BURBANK
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State | CA
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Zip | 91504-4152
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Country | US
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Telephone | 818-206-7236
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | FADI IBRAHIM
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Credential |
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Telephone | 818-206-7236
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZC0500X
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Taxonomy Name | Cytopathology Physician
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License Number |
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License Number State | CA
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