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Organization
PROCREATE 4D LLC
Active
Organization
PROCREATE 4D LLC
Active
Other names
procreate 4D
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE FERNANDO FARIAS (CEO)
(626) 316-0829
Entity
Organization
Contact information
Practice address
5161 POMONA BLVD STE 213, LOS ANGELES, CA 90022-1749
(626) 316-0829
Mailing address
5161 POMONA BLVD STE 213, LOS ANGELES, CA 90022-1749
(626) 316-0829
Taxonomy
Speciality
Code
Description
License number
State
2085U0001X
Diagnostic Ultrasound Physician
Primary
0002946802-0001-1
CA
Other
Enumeration date
01/08/2017
Last updated
01/08/2017
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