Provider Demographics
NPI:1184817108
Name:HIBM RESEARCH GROUP, INC.
Entity Type:Organization
Organization Name:HIBM RESEARCH GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DARVISH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-789-1033
Mailing Address - Street 1:18341 SHERMAN WAY
Mailing Address - Street 2:SUITE 201A
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-4472
Mailing Address - Country:US
Mailing Address - Phone:818-789-1033
Mailing Address - Fax:818-304-7136
Practice Address - Street 1:18341 SHERMAN WAY
Practice Address - Street 2:SUITE 201A
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4472
Practice Address - Country:US
Practice Address - Phone:818-789-1033
Practice Address - Fax:818-304-7136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05D0992853OtherMEDICARE/MEDICAID PIN