Organization
BIOSTEM,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHENSON O BAMIDELE (CEO)
(866) 894-7195
Entity
Organization
Contact information
Practice address
4000 LONG BEACH BVLD, SUITE 226, LONG BEACH, CA 90807
(866) 894-7195
Mailing address
14111 FREEWAY DR STE 312, SANTA FE SPRINGS, CA 90670-5822
(866) 894-7195
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
RAML 2236-36
CA
207UN0901X
Nuclear Cardiology Physician
RAML 1258-19
CA
2471N0900X
Nuclear Medicine Technology Radiologic Technologist
Primary
RHN 2003
CA
Other
Enumeration date
01/15/2009
Last updated
01/15/2009
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