Provider Demographics
NPI:1326421181
Name:YANDOLINO, BRIAN (CCI SONOGRAPHER)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:YANDOLINO
Suffix:
Gender:M
Credentials:CCI SONOGRAPHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 N KILKEA DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-2226
Mailing Address - Country:US
Mailing Address - Phone:818-282-3334
Mailing Address - Fax:
Practice Address - Street 1:351 N KILKEA DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-2226
Practice Address - Country:US
Practice Address - Phone:818-282-3334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-29
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00081385246W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Cardiology