Reveal Diagnostic Imaging of California LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

REVEAL DIAGNOSTIC IMAGING OF CALIFORNIA LLC

Doing business as

Diagnostic Health Los Angeles

Practice address

6801 Park Ter
Suite 100
Los Angeles, CA 90045-1543

Phone

(310) 665-7180

Fax

(310) 665-7184

NPI assigned

May 8, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Linda A Pelkey

Title

Credentialing Manager

Phone

(205) 981-4848

Specialties & licenses 1

Addresses

Other names 1

• Diagnostic Health Los Angeles Doing business as

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325808000000",
    "number": "1164471157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 INVERNESS CENTER PKWY",
            "address_2": "SUITE 425",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352424814",
            "telephone_number": "205-981-4848",
            "fax_number": "205-994-7018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 PARK TER",
            "address_2": "SUITE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900451543",
            "telephone_number": "310-665-7180",
            "fax_number": "310-665-7184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVEAL DIAGNOSTIC IMAGING OF CALIFORNIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2012-01-06",
        "status": "A",
        "authorized_official_last_name": "PELKEY",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "205-981-4848",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diagnostic Health Los Angeles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert Martin Reuter, M.D.
• Rev Physical Therapy and Performance
• Revadee Tan Veranunt DDS
• Pari Revankar
• Bradley Revard
• Claudia Reveles
• Danitza Reveles, LMFT
• Stephanie Reveles, VN
• Luis Francisco Revelo Herrera
• Armida Revelo, REGISTERED NURSE

• Physiological Laboratory in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physiological Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2012; 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.