NPI 1013131796

Innovative Diagnostic Medical Group

Organisation Physiological Laboratory Los Angeles, CA

Practice location

Address: 1801 Century Park East Suite 1040, Los Angeles, CA 90067
Phone: (310) 553-7980
Fax: (310) 943-3279

Authorised official

Name: Sean Ataee
Title: Medical Director/Owner
Phone: (310) 553-7960

Registered specialties (2)

Physiological Laboratory Primary

Laboratories Taxonomy 293D00000X Licence A44107 (CA)

Other Physiological Laboratory providers in California →

Physical Medicine & Rehabilitation Physician

Allopathic & Osteopathic Physicians Taxonomy 208100000X Licence A106704 (CA)

Other Physical Medicine & Rehabilitation providers in California →

Registry record

NPI: 1013131796
Entity type: Organization
NPI issued: 12 Apr 2007
Record last updated: 16 Dec 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.