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General NPI Number Information
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NPI Number | 1902012040
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Entity Type | Organization
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Legal Business Name | AMERICAN INSTITUTE OF MUSCULOSKELETAL DIAGNOSTIC ULTRASOUND (AIMDUS)
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 08/24/2011
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Provider Practice Location Address
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Address Line | 1441 BROADWAY
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City | SANTA MONICA
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State | CA
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Zip | 90404-2711
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Country | US
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Telephone | 310-456-6182
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Fax | 310-456-9092
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Provider Business Mailing Address
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Address Line | 1441 BROADWAY
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City | SANTA MONICA
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State | CA
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Zip | 60404-2710
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Country | US
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Telephone | 310-456-6182
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Fax | 310-456-9092
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALEX KALIAKIN
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Credential | D.C.
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Telephone | 310-456-6182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC14105
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | G35245
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License Number State | CA
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Taxonomy #4
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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 | CA
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