Organization
MEDULTRASOUND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK PRAVIN (OWNER)
(323) 350-3543
Entity
Organization
Contact information
Practice address
5310 ZELZAH AVE, #105, ENCINO, CA 91316-2212
(323) 350-3543
Mailing address
5310 ZELZAH AVE, #105, ENCINO, CA 91316-2212
(323) 350-3543
Taxonomy
Speciality
Code
Description
License number
State
246XS1301X
Sonography Specialist/Technologist Cardiovascular
—
—
2471S1302X
Sonography Radiologic Technologist
Primary
—
—
2471V0105X
Vascular Sonography Radiologic Technologist
—
—
Other
Enumeration date
05/29/2015
Last updated
05/29/2015
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