Organization Active NPI

Vachagan Akopyan

Doing business as p h diagnostics

  • Clinical Medical Laboratory
  • Dixon, IL
National Provider Identifier
1366582629
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
VACHAGAN AKOPYAN
Doing business as
p h diagnostics
Practice address
102 S Hennepin Ave # 195
Dixon, IL 61021-3083
Phone
(815) 713-6589
NPI assigned
Feb 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Vachagan Akopyan
Title
President
Phone
(815) 713-6589

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X IL Primary

Addresses

Primary practice location

102 S Hennepin Ave # 195
Dixon, IL 61021-3083

Mailing address

14417 Chase St # 206
Panorama City, CA 91402-3017

Other names 1

  • p h diagnostics Doing business as

National Provider Directory

National Provider Directory

Locations

102 S Hennepin Ave
Ste 206
Dixon, IL 61021
Phone (815) 713-6589

102 S Hennepin Ave
#195
Dixon, IL 61021
Phone (815) 713-6589

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366582629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14417 CHASE ST # 206",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914023017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 S HENNEPIN AVE # 195",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213083",
            "telephone_number": "815-713-6589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VACHAGAN AKOPYAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AKOPYAN",
        "authorized_official_first_name": "VACHAGAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-713-6589"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "p h diagnostics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dixon, IL

Sources for this page

  • 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.