Provider Demographics
NPI:1356677744
Name:HEALTH NETWORK LABORATORIES
Entity Type:Organization
Organization Name:HEALTH NETWORK LABORATORIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VIJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:VAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-279-3568
Mailing Address - Street 1:10929 VANOWEN ST
Mailing Address - Street 2:STE 143
Mailing Address - City:N HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91605-6426
Mailing Address - Country:US
Mailing Address - Phone:818-279-3568
Mailing Address - Fax:
Practice Address - Street 1:10929 VANOWEN ST
Practice Address - Street 2:STE 143
Practice Address - City:N HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91605-6426
Practice Address - Country:US
Practice Address - Phone:818-279-3568
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2081P0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation MedicineGroup - Single Specialty