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General NPI Number Information
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NPI Number | 1932342326
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Entity Type | Organization
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Legal Business Name | CENTER FOR FETAL MEDICINE AND WOMAN'S ULTRASOUND
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Dates
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Enumeration Date | 04/14/2009
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Last Update Date | 09/13/2011
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Provider Practice Location Address
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Address Line | 6310 SAN VICENTE BLVD 520
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City | LOS ANGELES
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State | CA
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Zip | 90048-5426
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Country | US
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Telephone | 323-857-1069
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Fax |
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Provider Business Mailing Address
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Address Line | 6310 SAN VICENTE BLVD 520
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City | LOS ANGELES
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State | CA
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Zip | 90048-5426
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Country | US
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Telephone | 323-857-1069
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. WENDY PLATT
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Credential | RN
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Telephone | 323-857-1069
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 659727-29
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License Number State | CA
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