Vitae Diagnostics Incorporated

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

05D2044828 Issued in CA

Legal business name

VITAE DIAGNOSTICS INCORPORATED

Practice address

3838 Del Amo Blvd Ste 202
Torrance, CA 90503-7710

Phone

(310) 376-5812

Fax

(310) 598-2120

NPI assigned

Jun 26, 2013

Organization subpart

No

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

Authorized official

Name

Issam Kabbani

Title

Owner

Phone

(310) 376-5812

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647302400000",
    "number": "1437599164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 609",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902770609",
            "telephone_number": "310-376-5812",
            "fax_number": "310-598-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 DEL AMO BLVD STE 202",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905037710",
            "telephone_number": "310-376-5812",
            "fax_number": "310-598-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAE DIAGNOSTICS INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-26",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A",
        "authorized_official_last_name": "KABBANI",
        "authorized_official_first_name": "ISSAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-376-5812"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "05D2044828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Torrance, CA
• Providers in Torrance, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.