Anthony Bledin M.D. Inc
Organization Active NPI Clinical Medical Laboratory · Los Angeles, CA
NPI 1295997484 · NPPES record last updated Jun 28, 2008
Key facts
- NPI
- 1295997484
- 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
- 3663 W 6TH St Ste 105
Los Angeles, CA 90020-3047 - Phone
- (213) 383-0112
- NPI assigned
- Jun 28, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Anthony G Bledin, M.D.
- Title
- Radiologist
- Phone
- (818) 494-9940
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | C42124 | CA | Yes |
Addresses
Primary practice location
3663 W 6TH St Ste 105
Los Angeles, CA 90020-3047
Mailing address
1851 Holser Walk Ste 220
Oxnard, CA 93036-2626
Phone (805) 988-1111
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00C421240 | Medicaid | CA |
Other names
- L. A. Medical Imaging Center
Other providers in Los Angeles, CA
- Antanta Medical Specialists, Inc
- Andrea Claire Antenucci
- Erin Antes
- Anthonia Memorial Center Inc
- Anthony Bledin M.D. Inc
- Anthony Bledin M.D. Inc
- Anthony Bledin MD Inc
- Anthony Gayfield
- Anthony Martin Mills M D a Medical Corporation
- Anthony Martin Mills, M.D., Pharmacy Inc.
All providers in Los Angeles, 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 Jun 28, 2008. 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.