Provider Demographics
NPI:1053882092
Name:PRECISION ULTRASOUND INC
Entity type:Organization
Organization Name:PRECISION ULTRASOUND INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLNAZARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-970-5008
Mailing Address - Street 1:303 N GLENOAKS BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1118
Mailing Address - Country:US
Mailing Address - Phone:818-970-5008
Mailing Address - Fax:
Practice Address - Street 1:303 N GLENOAKS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1118
Practice Address - Country:US
Practice Address - Phone:818-970-5008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PUI1958OtherNO LICENSE
PUI1958OtherNONE LICENSE