Organization Active NPI

Medical Diagnostic Associates, a Medical Corporation

  • Specialist
  • Westlake Village, CA
National Provider Identifier
1598838617
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MEDICAL DIAGNOSTIC ASSOCIATES, A MEDICAL CORPORATION
Practice address
5706 Corsa Ave Ste 200-O
Westlake Village, CA 91362-4057
Phone
(800) 400-4674
Fax
(818) 251-1112
NPI assigned
Nov 16, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Jack Weinberg
Title
Coo
Phone
(800) 400-4674

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X CA Primary

Addresses

Primary practice location

5706 Corsa Ave Ste 200-O
Westlake Village, CA 91362-4057

Mailing address

20750 Ventura Blvd Ste 106
Woodland Hills, CA 91364-6647
Phone (800) 400-4674

Other names 1

  • MDIA, A Medical Corporation Other name

National Provider Directory

National Provider Directory

Locations

5706 Corsa Ave
Ste 200O
Westlake Village, CA 91362
Phone (800) 400-4674

20750 Ventura Blvd
Ste 106
Woodland Hills, CA 91364

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598838617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20750 VENTURA BLVD STE 106",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913646647",
            "telephone_number": "800-400-4674",
            "fax_number": "818-251-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5706 CORSA AVE STE 200-O",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913624057",
            "telephone_number": "800-400-4674",
            "fax_number": "818-251-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL DIAGNOSTIC ASSOCIATES, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "800-400-4674",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MDIA, A Medical Corporation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Westlake Village, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.