Allstate Investment Realty Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

CLF10750 Issued in CA

Legal business name

ALLSTATE INVESTMENT REALTY INC

Doing business as

Northwest Lab

Practice address

10133 Riverside Dr
Toluca Lake, CA 91602-2533

Phone

(818) 752-6030

Fax

(818) 752-6033

NPI assigned

May 26, 2006

Last updated

Jan 11, 2013By 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

Mr. Mike Avedissian

Title

President

Phone

(818) 752-6030

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Northwest Lab Doing business as

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357862400000",
    "number": "1487600565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10133 RIVERSIDE DR",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916022533",
            "telephone_number": "818-752-6030",
            "fax_number": "818-752-6033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10133 RIVERSIDE DR",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916022533",
            "telephone_number": "818-752-6030",
            "fax_number": "818-752-6033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLSTATE INVESTMENT REALTY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2013-01-11",
        "status": "A",
        "authorized_official_last_name": "AVEDISSIAN",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-752-6030",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CLF10750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB8782F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Medical Laboratory in Toluca Lake, CA
• Providers in Toluca Lake, 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 Jan 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.