Organization
SOUTH COAST DIAGNOSTIC MEDICAL GROUP
Active
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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