Organization
INNOVATIVE DIAGNOSTIC MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEAN ATAEE M.D. (MEDICAL DIRECTOR/OWNER)
(310) 553-7960
Entity
Organization
Contact information
Practice address
1801 CENTURY PARK EAST, SUITE 1040, LOS ANGELES, CA 90067
(310) 553-7980
(310) 943-3279
Mailing address
1801 CENTURY PARK EAST, SUITE 1040, LOS ANGELES, CA 90067
(310) 553-7980
(310) 943-3279
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
A106704
CA
293D00000X
Physiological Laboratory
Primary
A44107
CA
Other
Enumeration date
04/12/2007
Last updated
12/16/2010
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