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General NPI Number Information
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NPI Number | 1992924146
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Entity Type | Organization
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Legal Business Name | MEDIPACE POL
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9033 WILSHIRE BLVD 5TH FLOOR
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-1837
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Country | US
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Telephone | 310-550-6240
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Fax |
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Provider Business Mailing Address
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Address Line | 9033 WILSHIRE BLVD 5TH FLOOR
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-1837
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Country | US
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Telephone |
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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 | MERCEDES BIN
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Credential |
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Telephone | 310-550-6242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | CLF4840
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License Number State | CA
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