Organization
SOUTH COAST DIAGNOSTIC MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MINA K. FISHER (OFFICE MANAGER)
(310) 500-6804
Entity
Organization
Contact information
Practice address
7095 HOLLYWOOD BLVD, 742, LOS ANGELES, CA 90028-8903
(310) 431-5753
Mailing address
7095 HOLLYWOOD BLVD, 742, LOS ANGELES, CA 90028-8903
(310) 431-5753
Taxonomy
Speciality
Code
Description
License number
State
207YX0901X
Otology & Neurotology Physician
Primary
A60418
CA
Other
Enumeration date
08/25/2009
Last updated
08/25/2009
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