MEDICARE: HOPE DIAGNOSTICS 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
1	246ZE0600X	Electroneurodiagnostic Specialist/Technologist
2	2085U0001X	Diagnostic Ultrasound Physician

General Provider Information

NPI Number	:	1255986329
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPE DIAGNOSTICS INC

Provider Business Mailing Address
First Line	:	10999 RIVERSIDE DR 204
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91602-2239
Country	:	US
Telephone Number	:	818-691-3344
Fax Number	:	818-691-3363

Provider Business Practice Location Address
First Line	:	10999 RIVERSIDE DR 204
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91602-2239
Country	:	US
Telephone Number	:	818-691-3344
Fax Number	:	818-691-3363

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ROMAN BATULIN
Credential	:
Telephone Number	:	818-691-3344

Provider Enumeration Date	:	08/06/2019
Last Update Date	:	08/04/2020

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Directions to “HOPE DIAGNOSTICS INC ” Practice Location

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