Express Diagnostics, Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

134513-57 Issued in CA

Legal business name

EXPRESS DIAGNOSTICS, INC

Practice address

15130 Ventura Blvd
Ste 221
Sherman Oaks, CA 91403-3372

Phone

(818) 783-6107

Fax

(866) 241-3280

NPI assigned

Jun 20, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Roman Shayevich

Title

President

Phone

(818) 783-6107

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicholas N Dzebolo, MD

  • Interventional Cardiology Physician
  • Sacramento, CA
  • NPI 1932239837
  NPD
• Daniel R Heitz, MD

  • Diagnostic Radiology Physician
  • Pomona, CA
  • NPI 1962550376
  NPD
• George Mednik, M.D.

  • Diagnostic Radiology Physician
  • Los Angeles, CA
  • NPI 1902858368
  NPD
• Nina L Zasorin, MD

  • Neurological Surgery Physician
  • Los Angeles, CA
  • NPI 1952437626
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013912518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15130 VENTURA BLVD",
            "address_2": "STE 221",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914033372",
            "telephone_number": "818-783-6107",
            "fax_number": "866-241-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15130 VENTURA BLVD",
            "address_2": "STE 221",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914033372",
            "telephone_number": "818-783-6107",
            "fax_number": "866-241-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS DIAGNOSTICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAYEVICH",
        "authorized_official_first_name": "ROMAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-783-6107",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "134513-57",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "ZZZ08080Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Express Dental
• Express Services Healthcare, Inc.
• Alexi Eyvazi, DDS
• Rita Ezadjian
• Daniela Fabian
• Hannah Fagerbakke

• Clinical Medical Laboratory in Sherman Oaks, CA
• Providers in Sherman Oaks, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.