Organization Name: | IPB MEDICAL DIAGNOSTIC, INC. |
NPI Number: | 1144391947 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PAVEL BAIMKIN (PRESIDENT) |
Mailing Address: | 8939 S Sepulveda Bl Suite 504 Los Angeles |
State: | CA US |
Postal Code: | 900453631 |
Phone Number: | 3106495264 |
Fax Number: | 3108221062 |
NPI Enumeration Date: | 11/13/2006 |
NPI Last Update Date: | 07/08/2007 |
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 |