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General NPI Number Information
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NPI Number | 1912714619
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Entity Type | Organization
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Legal Business Name | SONOMED DIAGNOSTIC, INC.
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 639 S GLENWOOD PL # 203
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City | BURBANK
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State | CA
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Zip | 91506-2819
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Country | US
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Telephone | 818-433-7582
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Fax |
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Provider Business Mailing Address
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Address Line | 639 S GLENWOOD PL # 203
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City | BURBANK
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State | CA
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Zip | 91506-2819
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Country | US
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Telephone | 818-433-7582
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Fax | 818-433-7583
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | VAHE GALSTYAN
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Credential |
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Telephone | 818-281-3560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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