| Doctor Name: | JAID GORBAN |
| NPI Number: | 1073941662 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 6931 Van Nuys Blvd Ste 317 Van Nuys, CA - 914053998 |
| Business Phone Number: | 8187426555 |
| Business Fax Number: | 8187426556 |
| Mailing Address: | 5242 Vesper Ave Apt 2, SHERMAN OAKS |
| State: | CA |
| Postal Code: | 914114091 |
| Phone Number: | 8187426555 |
| Fax Number: | 8187426556 |
| NPI Enumeration Date: | 10/17/2013 |
| NPI Last Update Date: | 10/17/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 293D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Laboratories |
| Taxonomy Classification: | Physiological Laboratory |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A laboratory that operates independently of a hospital and physician |