Odyssey Diagnostics Inc

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

ODYSSEY DIAGNOSTICS INC

Practice address

9190 W Olympic Blvd
Suite 237
Beverly Hills, CA 90212-3540

Phone

(310) 500-6410

Fax

(818) 699-6775

NPI assigned

May 10, 2016

Last updated

May 10, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paul Berg, ARDMS

Title

President, Ceo

Phone

(310) 500-6410

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462838400000",
    "number": "1295181162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9190 W OLYMPIC BLVD",
            "address_2": "SUITE 237",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902123540",
            "telephone_number": "310-500-6410",
            "fax_number": "818-699-6775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9190 W OLYMPIC BLVD",
            "address_2": "SUITE 237",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902123540",
            "telephone_number": "310-500-6410",
            "fax_number": "818-699-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODYSSEY DIAGNOSTICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-10",
        "last_updated": "2016-05-10",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "310-500-6410",
        "authorized_official_credential": "ARDMS"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physiological Laboratory in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Physiological Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; 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.