Organization
MODERN URODYNAMICS MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN SCOTT SPARKS M.D (MD)
(323) 654-0356
Entity
Organization
Contact information
Practice address
7855 SANTA MONICA BLVD, WEST HOLLYWOOD, CA 90046-5344
(323) 654-0356
(323) 297-5220
Mailing address
7855 SANTA MONICA BLVD, WEST HOLLYWOOD, CA 90046-5344
(323) 654-0356
(323) 297-5220
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A103568
CA
Other
Enumeration date
06/11/2009
Last updated
06/11/2009
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