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NPI Code Detail

MEDICARE: PRECISION ULTRASOUND INC

MEDICARE: PRECISION ULTRASOUND INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085U0001XDiagnostic Ultrasound Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PUI1958OTHERNO LICENSE
2PUI1958OTHERNONE LICENSE

General Provider Information

NPI Number : 1053882092
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRECISION ULTRASOUND INC
Provider Business Mailing Address
First Line : 303 N GLENOAKS BLVD STE 200
Second Line :
City : BURBANK
State : CA
Zip : 91502-1118
Country : US
Telephone Number : 818-970-5008
Fax Number :
Provider Business Practice Location Address
First Line : 303 N GLENOAKS BLVD STE 200
Second Line :
City : BURBANK
State : CA
Zip : 91502-1118
Country : US
Telephone Number : 818-970-5008
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ANDRE GOLNAZARIAN
Credential :
Telephone Number : 818-970-5008
Provider Enumeration Date : 12/17/2018
Last Update Date : 12/17/2018

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