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General NPI Number Information
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NPI Number | 1760195325
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Entity Type | Organization
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Legal Business Name | GENERAL PROMED CENTER INC
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Dates
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Enumeration Date | 12/28/2022
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Last Update Date | 12/28/2022
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Provider Practice Location Address
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Address Line | 17620 SHERMAN WAY STE 205
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City | LAKE BALBOA
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State | CA
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Zip | 91406-3527
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Country | US
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Telephone | 818-600-8847
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Fax | 818-600-8846
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Provider Business Mailing Address
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Address Line | 17620 SHERMAN WAY STE 205
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City | LAKE BALBOA
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State | CA
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Zip | 91406-3527
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Country | US
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Telephone | 818-600-8847
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Fax | 818-600-8846
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Authorized Official
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Title or Position | CEO/OWNER
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Name | GERASIM CHERKEZYAN
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Credential |
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Telephone | 818-600-8847
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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