Organization
WAVE MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY T DAVIS M.D. (CEO)
(310) 200-0945
Entity
Organization
Contact information
Practice address
2070 CENTURY PARK E FL 5, LOS ANGELES, CA 90067-1907
(310) 200-0945
Mailing address
122 SHELDON ST, EL SEGUNDO, CA 90245-3915
(310) 200-0945
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Enumeration date
08/10/2006
Last updated
10/14/2007
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