Organization · Type 2 NPI
Innovative Diagnostic Medical Group
Physiological Laboratory · Los Angeles, CA
Practice location
1801 Century Park East, Suite 1040
Los Angeles, CA 90067
Fax (310) 943-3279
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | A106704 (CA) |
| Physiological Laboratory Primary | 293D00000X | A44107 (CA) |
Physiological Laboratory: A laboratory that operates independently of a hospital and physician's office to furnish physiological diagnostic services (e.g. EEG's , EKG's, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical labora…
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About NPI 1013131796
Innovative Diagnostic Medical Group's National Provider Identifier is 1013131796, issued on Apr 12, 2007. The primary taxonomy on file is Physiological Laboratory (293D00000X), and the practice location is in Los Angeles, CA. The record was last updated on Dec 16, 2010.