Organization
INSTITUTE OF DIAGNOSTIC MEDICINE
Active
Organization
INSTITUTE OF DIAGNOSTIC MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KHASHAYAR POURMAND R.NCS.T. (PRESIDENT OF CORPORATION)
(310) 592-5067
Entity
Organization
Contact information
Practice address
6230 RESEDA BLVD APT 213, TARZANA, CA 91335-6930
(310) 592-5067
Mailing address
6230 RESEDA BLVD APT 213, TARZANA, CA 91335-6930
(310) 592-5067
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
704
MA
Other
Enumeration date
12/08/2006
Last updated
08/06/2007
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