Organization Active NPI

Family Medical Diagnostics Inc

  • Diagnostic Radiology Physician
  • Reseda, CA
National Provider Identifier
1417567710
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
FAMILY MEDICAL DIAGNOSTICS INC
Practice address
19231 Victory Blvd Ste 356
Reseda, CA 91335-6308
Phone
(747) 265-6197
Fax
(747) 265-6098
NPI assigned
Aug 3, 2020
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Aspram Aznavour
Title
President
Phone
(747) 240-0747

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20210107001038 CA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 4082027271 Practice locations: Glendale, CA
O20210331002174 CA Part B Supplier - Portable X-Ray Supplier 4082027271 Practice locations: Reseda, CA

National Provider Directory

National Provider Directory

Locations

19231 Victory Blvd
Ste 356
Reseda, CA 91335
Phone (747) 265-6197

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X

Addresses

NPPES NPI Registry

Primary practice location

19231 Victory Blvd Ste 356
Reseda, CA 91335-6308

Mailing address

19231 Victory Blvd Ste 356
Reseda, CA 91335-6308
Phone (747) 265-6197

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 18, 2022.

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650240000000",
    "number": "1417567710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19231 VICTORY BLVD STE 356",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913356308",
            "telephone_number": "747-265-6197",
            "fax_number": "747-265-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19231 VICTORY BLVD STE 356",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913356308",
            "telephone_number": "747-265-6197",
            "fax_number": "747-265-6098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL DIAGNOSTICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-03",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A",
        "authorized_official_last_name": "AZNAVOUR",
        "authorized_official_first_name": "ASPRAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "747-240-0747"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reseda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.