Organization
EXECUTIVE HEALTH LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MASIH NOOR (CEO)
(424) 265-9992
Entity
Organization
Contact information
Practice address
19234 VANOWEN ST STE B, RESEDA, CA 91335-5000
(424) 265-9992
Mailing address
17412 VENTURA BLVD # 422, ENCINO, CA 91316-3827
(424) 265-9992
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
11/13/2021
Last updated
11/13/2021
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