California Local Diagnostic,Inc

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

TG226 Issued in CA

Legal business name

CALIFORNIA LOCAL DIAGNOSTIC,INC

Practice address

216 S Jackson St
Suite # 101
Glendale, CA 91205-1177

Phone

(818) 244-0202

NPI assigned

Jun 15, 2006

Organization subpart

No

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

Authorized official

Name

Arytun Khoudagoulian

Title

President

Phone

(818) 244-0202

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366486136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 S JACKSON ST",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051191",
            "telephone_number": "818-244-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 S JACKSON ST",
            "address_2": "SUITE # 101",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051177",
            "telephone_number": "818-244-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA LOCAL DIAGNOSTIC,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KHOUDAGOULIAN",
        "authorized_official_first_name": "ARYTUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-244-0202"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "TG226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Maintenance Organization in Glendale, CA
• Providers in Glendale, CA by specialty
• Health Maintenance Organization 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.