Provider Demographics
NPI:1417594201
Name:PERFORMANCE CONSULTING MANAGMENT INC
Entity Type:Organization
Organization Name:PERFORMANCE CONSULTING MANAGMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/BILLER
Authorized Official - Prefix:
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-536-6100
Mailing Address - Street 1:19562 VENTURA BLVD STE 218
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-6069
Mailing Address - Country:US
Mailing Address - Phone:424-410-3099
Mailing Address - Fax:
Practice Address - Street 1:1619 CECIL AVE
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-1548
Practice Address - Country:US
Practice Address - Phone:424-394-2999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-29
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile