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General NPI Number Information
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NPI Number | 1851311757
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Entity Type | Organization
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Legal Business Name | I.S.B. DIAGNOSTIC SERVICES,INC.
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 14557 FRIAR ST STUITE #140
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City | VAN NUYS
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State | CA
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Zip | 91411
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Country | US
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Telephone | 818-782-2688
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Fax | 818-782-2777
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Provider Business Mailing Address
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Address Line | 14557 FRIAR ST STUITE #140
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City | VAN NUYS
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State | CA
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Zip | 91411
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Country | US
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Telephone | 818-782-2688
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Fax | 818-782-2777
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Authorized Official
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Title or Position | OWNER
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Name | MRS. IRINA BRANDALIS
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Credential |
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Telephone | 818-782-2688
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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 | TD088
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License Number State | CA
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