Family Medical Diagnostics Inc

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

Last updated

Apr 18, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Aspram Aznavour

Title

President

Phone

(747) 240-0747

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417567710. Details of each certification follow.

• CCN 05X0010073 Portable X-ray supplier · Active · Name & address match · Details

Portable X-ray supplier certification: CCN 05X0010073

Legal name

FAMILY MEDICAL DIAGNOSTICS INC

Certification status

Active

Provider type (POS)

Portable X-ray supplier

Participating since

Jan 26, 2022

Last certification

Jan 26, 2022

Ownership / control type

Corporation

Facility address

19231 Victory Blvd, Suite 356
Reseda, CA 91335

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Frederick L Orr, M.D.

  • Diagnostic Radiology Physician
  • Colton, CA
  • NPI 1295830321
  NPD
• Darren Michael Buono, MD

  • Diagnostic Radiology Physician
  • Las Vegas, NV
  • NPI 1912004698
  NPD
• Christopher Alki Michaeles, M.D.

  • Cardiovascular Disease Physician
  • Olean, NY
  • NPI 1225060684
  NPD
• George Nicholas Welch, MD

  • Cardiovascular Disease Physician
  • Portland, ME
  • NPI 1144258336
  NPD

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

{
    "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": []
}

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• Diagnostic Radiology Physician in Reseda, CA
• Providers in Reseda, CA by specialty
• Diagnostic Radiology Physician in California

• 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; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.