NPIMap

Organization Active NPI

Kan-Di-Ki LLC

  • Diagnostic Ultrasound Physician
  • North Hollywood, CA
National Provider Identifier
1184930752
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X
Legal business name
KAN-DI-KI LLC
Practice address
12612 Raymer St
North Hollywood, CA 91605-4307
Phone
(818) 549-1880
Fax
(818) 333-7186
NPI assigned
Aug 20, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Authorized official

Name
Mr. Brian C Cuomo
Title
Authorized Official/Cfo
Phone
(800) 786-8015

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Ultrasound PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085U0001X Primary

Addresses

Primary practice location

12612 Raymer St
North Hollywood, CA 91605-4307

Mailing address

215 Schilling Cir Ste 114
Hunt Valley, MD 21031-1113
Phone (800) 786-8015

Other names 2

  • DIAGNOSTIC LABORATORIES Doing business as
  • TridentCare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060911000613 CA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 5991737140 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: North Hollywood, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Diagnostic Xray17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Practitioners & affiliated clinicians

Practitioners 49

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

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1282262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773187200000",
    "number": "1184930752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 SCHILLING CIR STE 114",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "210311113",
            "telephone_number": "800-786-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12612 RAYMER ST",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916054307",
            "telephone_number": "818-549-1880",
            "fax_number": "818-333-7186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAN-DI-KI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-20",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A",
        "authorized_official_last_name": "CUOMO",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL/CFO",
        "authorized_official_telephone_number": "800-786-8015",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DIAGNOSTIC LABORATORIES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TridentCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; 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.