Active NPI
Family Medical Diagnostics Inc
- Diagnostic Radiology Physician
- Reseda, CA
National Provider Identifier
1417567710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- 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.
-
- Diagnostic Radiology Physician
- Las Vegas, NV
- NPI 1912004698
Diagnostic Radiology
-
- Cardiovascular Disease Physician
- Olean, NY
- NPI 1225060684
-
- Cardiovascular Disease Physician
- Portland, ME
- NPI 1144258336
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records 2
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations
19231 Victory Blvd
Ste 356
Reseda, CA 91335
Phone (747) 265-6197
Specialties & licenses 2
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary | ||
| Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 335V00000X |
Addresses
NPPES NPI RegistryPrimary 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.