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General NPI Number Information
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NPI Number | 1851658108
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Entity Type | Organization
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Legal Business Name | METRO STAR DIAGNOSTICS, INC.
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Dates
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Enumeration Date | 04/11/2012
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Last Update Date | 04/11/2012
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Provider Practice Location Address
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Address Line | 6221 WILSHIRE BLVD SUITE 326
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City | LOS ANGELES
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State | CA
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Zip | 90048-5201
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Country | US
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Telephone | 310-877-3020
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Fax | 310-218-2134
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Provider Business Mailing Address
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Address Line | 6221 WILSHIRE BLVD SUITE 326
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City | LOS ANGELES
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State | CA
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Zip | 90048-5201
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Country | US
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Telephone | 310-877-3020
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Fax | 310-218-2134
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Authorized Official
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Title or Position | CFO
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Name | MR. SINA MELAMED
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Credential |
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Telephone | 310-877-3020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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