| Idom Industries Inc. | |
|
171 N La Brea Ave Ste 204 Inglewood CA 90301-1246 | |
| (310) 671-0023 | |
| (310) 419-9409 |
| Full Name | Idom Industries Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 171 N La Brea Ave Ste 204, Inglewood, California |
| Authorized Official Name and Position | Byron Keith Idom (CEO) |
| Authorized Official Contact | 3106710023 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idom Industries Inc. 171 N La Brea Ave Ste 204 Inglewood CA 90301-1246 Ph: (310) 671-0023 | Idom Industries Inc. 171 N La Brea Ave Ste 204 Inglewood CA 90301-1246 Ph: (310) 671-0023 |
| NPI Number | 1477808293 |
|---|---|
| Provider Enumeration Date | 07/18/2012 |
| Last Update Date | 05/09/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477808293 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 193471 (California) | Primary |
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