Prohealth Neurodiagnostic, Inc.

Primary specialty

Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X

License

A87842 Issued in CA

Legal business name

PROHEALTH NEURODIAGNOSTIC, INC.

Practice address

6613 Columbus Ave
Van Nuys, CA 91405-4517

Phone

(818) 781-0457

NPI assigned

Oct 5, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Arsen Oganesyan

Title

Ceo/President

Phone

(818) 781-0457

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

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

{
    "created_epoch": "1254700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372982400000",
    "number": "1396070603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6613 COLUMBUS AVE",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914054517",
            "telephone_number": "818-781-0457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6613 COLUMBUS AVE",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914054517",
            "telephone_number": "818-781-0457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH NEURODIAGNOSTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-05",
        "last_updated": "2013-07-05",
        "status": "A",
        "authorized_official_last_name": "OGANESYAN",
        "authorized_official_first_name": "ARSEN",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "818-781-0457",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": "CA",
            "license": "A87842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Electroneurodiagnostic Specialist/Technologist in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Electroneurodiagnostic Specialist/Technologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.