Organization
ELECTRONIC WAVEFORM LAB, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN P HEANEY (PRESIDENT)
(714) 843-0463
Entity
Organization
Contact information
Practice address
5702 BOLSA AVE, HUNTINGTON BEACH, CA 92649-1128
(714) 843-0463
(714) 500-4093
Mailing address
5702 BOLSA AVE, HUNTINGTON BEACH, CA 92649-1128
(714) 843-0463
(714) 500-4093
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
01/18/2007
Last updated
09/28/2011
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