Marina Center Neurodiagnostics Inc | |
3011 Grayson Ave Venice CA 90291-4651 | |
(562) 201-3874 | |
(866) 441-8248 |
Full Name | Marina Center Neurodiagnostics Inc |
---|---|
Speciality | General Practice |
Location | 3011 Grayson Ave, Venice, California |
Authorized Official Name and Position | Edwards Michael (OWNER) |
Authorized Official Contact | 5622013874 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Marina Center Neurodiagnostics Inc 3011 Grayson Ave Venice CA 90291-4651 Ph: (562) 201-3874 | Marina Center Neurodiagnostics Inc 3011 Grayson Ave Venice CA 90291-4651 Ph: (562) 201-3874 |
NPI Number | 1891106712 |
---|---|
Provider Enumeration Date | 05/13/2014 |
Last Update Date | 05/13/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891106712 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | C3298806 (California) | Primary |
Venice Family Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 622 Rose Ave, Venice, CA 90291 Phone: 310-392-8636 | |