Organization
KMG DIAGNOSTIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MESROP KONANYAN (CEO)
(818) 548-5665
Entity
Organization
Contact information
Practice address
326 E BROADWAY BLVD, GLENDALE, CA 91205-1011
(818) 548-5665
(818) 548-5600
Mailing address
326 E BROADWAY BLVD, GLENDALE, CA 91205-1011
(818) 548-5665
(818) 548-5600
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
102175
CA
Other
Enumeration date
10/03/2006
Last updated
06/19/2008
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