Provider Demographics
NPI:1821708330
Name:VERTEBRAL MOTION DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:VERTEBRAL MOTION DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOVSESIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-773-8862
Mailing Address - Street 1:17002 STANLEY LN APT A
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-8217
Mailing Address - Country:US
Mailing Address - Phone:833-773-8862
Mailing Address - Fax:833-773-8862
Practice Address - Street 1:20998 REDWOOD RD
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5918
Practice Address - Country:US
Practice Address - Phone:833-773-8862
Practice Address - Fax:833-733-8862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-25
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Single Specialty