Anthony Bledin M.D. Inc
Organization Active NPI Clinical Medical Laboratory · Westlake Village, CA
NPI 1265653554 · NPPES record last updated Feb 19, 2024
Key facts
- NPI
- 1265653554
- 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
- 2820 Townsgate Rd
Suite 100a
Westlake Village, CA 91361-3000 - Phone
- (805) 367-8219
- Fax
- (805) 367-8222
- NPI assigned
- May 2, 2007
- 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.
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
2820 Townsgate Rd
Ste 100A
Westlake Vlg, CA 91361
Phone (805) 367-3821
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | C42124 | CA | Yes |
Addresses
Primary practice location
2820 Townsgate Rd
Suite 100a
Westlake Village, CA 91361-3000
Mailing address
1851 Holser Walk
Suite 220
Oxnard, CA 93036-2626
Phone (805) 494-9940
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00C421240 | Medicaid | CA |
Other names
- Big Oak Radiology INC
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All providers in Westlake Village, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.