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Organization

MEDICAL SCIENCE LABORATORY INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KAMBAKSH TAVAKOLI CHS (PRESIDENT)
(310) 360-0066
Entity
Organization

Contact information

Practice address
432 S SAN VICENTE BLVD STE 200, LOS ANGELES, CA 90048-4192
(310) 360-0066
(310) 360-0302
Mailing address
432 S SAN VICENTE BLVD STE 220, LOS ANGELES, CA 90048-4183
(310) 360-0066
(310) 360-0302

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
05D1082642
CA

Other

Enumeration date
09/05/2008
Last updated
03/17/2009
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