Anthony Bledin M.D. Inc
Organization Active NPI Clinical Medical Laboratory · Los Angeles, CA
NPI 1174809693 · NPPES record last updated Feb 19, 2024
Key facts
- NPI
- 1174809693
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Medical Laboratory 291U00000X
- License
- C42124 (CA)
- Legal business name
- ANTHONY BLEDIN M.D. INC
- Practice address
- 9201 Sunset Blvd.
Suite M-150
Los Angeles, CA 90069-3701 - Phone
- (310) 288-0310
- Fax
- (310) 288-0311
- NPI assigned
- Oct 28, 2011
- Organization subpart
- No
Authorized official
- Name
- Dr. Anthony G Bledin, M.D.
- Title
- Radiologist
- Phone
- (805) 988-1111
Other NPIs on the same Medicare enrollment 6
Corporate family (same tax ID) 9
Practitioners 1
-
Anthony G Bledin, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D1012674 | Anthony Martin Mills, MD Laboratory | Accreditation | Nov 10, 2026 |
| 05D2062983 | Anthony Martin Mills MD Inc- Research | Certificate of waiver | Jul 23, 2027 |
| 05D2089367 | Surgery on Sunset, Inc | Certificate of waiver | Jan 23, 2028 |
| 05D2314471 | Sunset Tower Surgery Center, LLC | Certificate of waiver | Nov 19, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120524000478 | CA | Part B Supplier - Clinic/Group Practice | 5890958110 |
Receives reassigned benefits from 1 practitioner 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Granada Hills, CA; Los Angeles, CA; Montebello, CA; Oxnard, CA; Westlake Village, CA; Woodland Hills, CA |
National Provider Directory
- Tax ID family
- Anthony Bledin MD Inc
Locations
9201 W Sunset Blvd
#150
West Hollywood, CA 90069
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | C42124 | CA | Yes |
Addresses
Primary practice location
9201 Sunset Blvd.
Suite M-150
Los Angeles, CA 90069-3701
Mailing address
1851 Holser Walk Ste 220
Oxnard, CA 93036-2626
Phone (805) 988-1111
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00C421240 | Medicaid | CA |
Other names
- Sunset Diagnostic Radiology
Other providers in Los Angeles, CA
- James Robert Antaki
- Antanta Medical Specialists, Inc
- Andrea Claire Antenucci
- Erin Antes
- Anthonia Memorial Center Inc
- Anthony Bledin M.D. Inc
- Anthony Bledin M.D. Inc
- Anthony Bledin MD Inc
- Anthony Gayfield
- Anthony Martin Mills M D a Medical Corporation
All providers in Los Angeles, CA · Clinical Medical Laboratory in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.