Provider Demographics
NPI:1710341862
Name:COMPREHENSIVE MEDICAL REPORTING SERVICES
Entity Type:Organization
Organization Name:COMPREHENSIVE MEDICAL REPORTING SERVICES
Other - Org Name:ADVANTAGE MED LEGAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:YOHAN
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:FEHRENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-528-8300
Mailing Address - Street 1:9040 FRIARS RD STE 410
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-5862
Mailing Address - Country:US
Mailing Address - Phone:619-528-8300
Mailing Address - Fax:619-528-8333
Practice Address - Street 1:9040 FRIARS RD., STE. 410
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108
Practice Address - Country:US
Practice Address - Phone:619-528-8300
Practice Address - Fax:619-528-8333
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPREHENSIVE MEDICAL REPORTING SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-04-05
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB2006002857174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty