Provider Demographics
NPI:1811368178
Name:REM NEURODIAGNOSTICS INC
Entity Type:Organization
Organization Name:REM NEURODIAGNOSTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FARSHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:FIROUZNAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-874-6336
Mailing Address - Street 1:7 MUSICK
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-1638
Mailing Address - Country:US
Mailing Address - Phone:877-874-6336
Mailing Address - Fax:877-874-6335
Practice Address - Street 1:4214 GREEN RIVER RD
Practice Address - Street 2:SUITE NUMBER 200
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92880-1669
Practice Address - Country:US
Practice Address - Phone:877-874-6336
Practice Address - Fax:877-874-6335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-13
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory