Van Nuys Diagnostic Services, Inc.

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

License

TG063 Issued in CA

Legal business name

VAN NUYS DIAGNOSTIC SERVICES, INC.

Practice address

2300 Huntington Dr
#B
San Marino, CA 91108-2641

Phone

(626) 237-0502

Fax

(626) 237-0503

NPI assigned

Jun 2, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Alexander Berezovsky

Title

President

Phone

(626) 237-0502

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206230400000",
    "number": "1093753204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HUNTINGTON DR",
            "address_2": "#B",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "911082641",
            "telephone_number": "626-403-2702",
            "fax_number": "626-403-2703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HUNTINGTON DR",
            "address_2": "#B",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "911082641",
            "telephone_number": "626-237-0502",
            "fax_number": "626-237-0503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN NUYS DIAGNOSTIC SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2008-03-23",
        "status": "A",
        "authorized_official_last_name": "BEREZOVSKY",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-237-0502",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "CA",
            "license": "TG063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Avendano Tostado, NP
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• Physiological Laboratory in San Marino, CA
• Providers in San Marino, CA by specialty
• Physiological Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.