Active NPI
Mediaid Diagnostic Inc
- Specialist
- Los Angeles, CA
National Provider Identifier
1265560122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 102999
- Legal business name
- MEDIAID DIAGNOSTIC INC
- Practice address
- 8127 Melrose Ave Ste 2
Los Angeles, CA 90046-7030 - Phone
- (131) 077-4774
- NPI assigned
- Mar 1, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Anait Grigorian
- Title
- Ceo
- Phone
- (310) 774-7747
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 102999 | CA | Primary |
Addresses
Primary practice location
8127 Melrose Ave Ste 2
Los Angeles, CA 90046-7030
Mailing address
PO Box 1429
Hollywood, CA 90078-1429
National Provider Directory
National Provider DirectoryLocations
8127 Melrose Ave
Ste 2
Los Angeles, CA 90046
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1265560122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1429",
"city": "HOLLYWOOD",
"state": "CA",
"postal_code": "900781429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8127 MELROSE AVE STE 2",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900467030",
"telephone_number": "131-077-4774"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDIAID DIAGNOSTIC INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-01",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "GRIGORIAN",
"authorized_official_first_name": "ANAIT",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "13107747747"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "CA",
"license": "102999",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.