Organization
INSTITUTE OF DIAGNOSITC MEDICINE & RESEARCH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KHASHAYAR POURMAND (CEO)
(310) 592-5067
Entity
Organization
Contact information
Practice address
833 S LOS ROBLES AVE, PASADENA, CA 91106-3716
(310) 592-5067
(714) 996-9267
Mailing address
833 S LOS ROBLES AVE, PASADENA, CA 91106-3716
(310) 592-5067
(714) 996-9267
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225092190
INDIV NPI
CA
Enumeration date
02/22/2016
Last updated
02/22/2016
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