MEDICARE: I-STATS MED 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	207Q00000X	Family Medicine Physician	A54497	CA

General Provider Information

NPI Number	:	1487987806
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	I-STATS MED INC

Provider Business Mailing Address
First Line	:	5870 MELROSE AVE
Second Line	:	SUITE 3744
City	:	LOS ANGELES
State	:	CA
Zip	:	90038-3700
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5870 MELROSE AVE
Second Line	:	SUITE 3744
City	:	LOS ANGELES
State	:	CA
Zip	:	90038-3700
Country	:	US
Telephone Number	:	323-303-1641
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MAURICE M VINCENT
Credential	:
Telephone Number	:	323-303-1641

Provider Enumeration Date	:	09/16/2009
Last Update Date	:	09/16/2009

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Directions to “I-STATS MED INC ” Practice Location

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