Organization
PERINATAL DIAGNOSTIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARYOUSH JADALI M.D. (PRESIDENT)
(800) 777-7406
Entity
Organization
Contact information
Practice address
2100 LYNN RD STE 125, THOUSAND OAKS, CA 91360-8032
(805) 777-7406
Mailing address
PO BOX 7448, THOUSAND OAKS, CA 91359-7448
(805) 643-9781
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
A48921
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A48921
—
CA
01
—
1908651
MEDIAL LIC
NJ
01
—
25MA06354400
MEDICAL LIC
NY
Enumeration date
12/06/2006
Last updated
05/22/2020
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