Organization
MARINA CENTER NEURODIAGNOSTICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARDS MICHAEL MD (OWNER)
(562) 201-3874
Entity
Organization
Contact information
Practice address
3011 GRAYSON AVE, VENICE, CA 90291-4651
(562) 201-3874
(866) 441-8248
Mailing address
3011 GRAYSON AVE, VENICE, CA 90291-4651
(562) 201-3874
(866) 441-8248
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
C3298806
CA
Other
Enumeration date
05/13/2014
Last updated
05/13/2014
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