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General NPI Number Information
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NPI Number | 1770180945
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Entity Type | Organization
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Legal Business Name | BELLONA DIAGNOSTICS INC
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Dates
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Enumeration Date | 10/01/2020
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | 6450 BELLINGHAM AVE STE G
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-1429
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Country | US
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Telephone |
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Fax |
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Provider Business Mailing Address
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Address Line | 6450 BELLINGHAM AVE STE G
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-1429
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Country | US
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Telephone | 818-752-1622
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ACHKHEN MARTIROSYAN
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Credential |
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Telephone | 747-295-8536
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225B00000X
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Taxonomy Name | Pulmonary Function Technologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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