| Organization Name: | FASTECH MOBILE EEG |
| NPI Number: | 1265662563 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERTA JEAN ESFANDIARFARD (E.EEG.T OWNER GENERAL PARTNER) |
| Mailing Address: | 3154 El Tejon Road Cameron Park |
| State: | CA US |
| Postal Code: | 956829108 |
| Phone Number: | 5304099607 |
| Fax Number: | |
| NPI Enumeration Date: | 07/21/2009 |
| NPI Last Update Date: | 07/21/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246ZE0500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Specialist/Technologist, Other |
| Taxonomy Specialization: | EEG |
| Taxonomy Definition: | |