Medline Diagnostic Center, Inc

Primary specialty

Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X

Legal business name

MEDLINE DIAGNOSTIC CENTER, INC

Practice address

1720 Colorado Blvd
Los Angeles, CA 90041-1338

Phone

(323) 254-8600

Fax

(323) 254-8700

NPI assigned

May 23, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Galina Panassenko

Title

Owner

Phone

(818) 254-8600

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356396170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 COLORADO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900411338",
            "telephone_number": "323-254-8600",
            "fax_number": "323-254-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 COLORADO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900411338",
            "telephone_number": "323-254-8600",
            "fax_number": "323-254-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDLINE DIAGNOSTIC CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PANASSENKO",
        "authorized_official_first_name": "GALINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-254-8600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sleep Disorder Diagnostic Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Sleep Disorder Diagnostic Clinic/Center in California

• 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.

Verify at the official NPI Registry.