MEDICARE: MEDICAL PRO HEALTH 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	335V00000X	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A77259	OTHER	CA	SUPERVISING PHYICIAN MEDICAL LICENSE

General Provider Information

NPI Number	:	1487185625
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL PRO HEALTH INC

Provider Business Mailing Address
First Line	:	1812 W BURBANK BLVD
Second Line	:	81
City	:	BURBANK
State	:	CA
Zip	:	91506
Country	:	US
Telephone Number	:	818-568-0006
Fax Number	:	888-730-7347

Provider Business Practice Location Address
First Line	:	2501 W BURBANK BLVD
Second Line	:	300
City	:	BURBANK
State	:	CA
Zip	:	91505-2347
Country	:	US
Telephone Number	:	818-568-0006
Fax Number	:	888-730-7347

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ALFRED LEVONIANS
Credential	:
Telephone Number	:	818-568-0006

Provider Enumeration Date	:	03/21/2017
Last Update Date	:	03/21/2017

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Directions to “MEDICAL PRO HEALTH INC ” Practice Location

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