Privilege Diagnostic | |
12501 Chandler Blvd Suite 102 Valley Village CA 91607-1941 | |
(818) 980-1171 | |
(818) 763-8750 |
Full Name | Privilege Diagnostic |
---|---|
Speciality | Psychiatry & Neurology - Diagnostic Neuroimaging |
Location | 12501 Chandler Blvd, Valley Village, California |
Authorized Official Name and Position | Gregory Davidov (CEO) |
Authorized Official Contact | 8189801171 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Privilege Diagnostic 12501 Chandler Blvd Suite 102 Valley Village CA 91607-1941 Ph: (818) 980-1171 | Privilege Diagnostic 12501 Chandler Blvd Suite 102 Valley Village CA 91607-1941 Ph: (818) 980-1171 |
NPI Number | 1255588273 |
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Provider Enumeration Date | 08/20/2008 |
Last Update Date | 07/23/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255588273 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084D0003X | Psychiatry & Neurology - Diagnostic Neuroimaging | (* (Not Available)) | Primary |
293D00000X | Physiological Laboratory | (* (Not Available)) | Secondary |
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