Organization
LA PUENTE MEDICAL DIAGNOSTICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOHAMMAD ALI DORAFSHAR (CONSULTANT)
(818) 999-0099
Entity
Organization
Contact information
Practice address
569 S AZUSA WAY, LA PUENTE, CA 91744-5113
(626) 861-4173
Mailing address
PO BOX 1147, CYPRESS, CA 90630-8147
(714) 995-5400
(714) 995-5467
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G43636
CA
Other
Enumeration date
07/14/2017
Last updated
04/10/2018
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