NPIMap

Organization Active NPI

La Puente Medical Diagnostics, Inc.

  • Diagnostic Radiology Physician
  • La Puente, CA
National Provider Identifier
1295257822
Registry record updated Apr 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G43636 Issued in CA
Legal business name
LA PUENTE MEDICAL DIAGNOSTICS, INC.
Practice address
569 S Azusa Way
La Puente, CA 91744-5113
Phone
(626) 861-4173
NPI assigned
Jul 14, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2018

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

Authorized official

Name
Mr. Mohammad Ali Dorafshar
Title
Consultant
Phone
(818) 999-0099

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X G43636 CA Primary

Addresses

Primary practice location

569 S Azusa Way
La Puente, CA 91744-5113

Mailing address

PO Box 1147
Cypress, CA 90630-8147
Phone (714) 995-5400

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523318400000",
    "number": "1295257822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1147",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906308147",
            "telephone_number": "714-995-5400",
            "fax_number": "714-995-5467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "569 S AZUSA WAY",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917445113",
            "telephone_number": "626-861-4173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA PUENTE MEDICAL DIAGNOSTICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-14",
        "last_updated": "2018-04-10",
        "status": "A",
        "authorized_official_last_name": "DORAFSHAR",
        "authorized_official_first_name": "MOHAMMAD ALI",
        "authorized_official_title_or_position": "CONSULTANT",
        "authorized_official_telephone_number": "818-999-0099",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G43636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Puente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2018; 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.