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Individual

MARK PRAVIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2385 ROSCOMARE RD, LOS ANGELES, CA 90077-1838
(323) 350-3543
Mailing address
2385 ROSCOMARE RD, E-17, LOS ANGELES, CA 90077-1838
(323) 350-3543

Taxonomy

Speciality
Code
Description
License number
State
246XS1301X
Sonography Specialist/Technologist Cardiovascular
2471S1302X
Sonography Radiologic Technologist
Primary
2471V0105X
Vascular Sonography Radiologic Technologist

Other

Enumeration date
07/13/2011
Last updated
07/13/2011
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