Avicenna Laboratory Diagnostics, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

CLF 00349262 Issued in CA

Legal business name

AVICENNA LABORATORY DIAGNOSTICS, INC.

Practice address

20011 Ventura Blvd Ste 1002a
Woodland Hills, CA 91364-2633

Phone

(818) 914-5597

Fax

(818) 914-5596

NPI assigned

Nov 7, 2016

Last updated

Nov 7, 2016By 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. Punzalan Rubio

Title

Director

Phone

(626) 201-9893

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1478476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478476800000",
    "number": "1679015788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20011 VENTURA BLVD STE 1002A",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913642633",
            "telephone_number": "818-914-5597",
            "fax_number": "818-914-5596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20011 VENTURA BLVD STE 1002A",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913642633",
            "telephone_number": "818-914-5597",
            "fax_number": "818-914-5596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVICENNA LABORATORY DIAGNOSTICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-07",
        "last_updated": "2016-11-07",
        "status": "A",
        "authorized_official_last_name": "RUBIO",
        "authorized_official_first_name": "PUNZALAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "626-201-9893",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CLF 00349262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Available Nurses Home Heathcare
• Andrew Christian Avalos
• Cynthia Avalos, B.A.
• Jose S Avalos Jr.
• Joann Susan Averill, PHARM.D.
• Brenda Lizeth Avila
• Joshua Avila
• Vanessa Avila
• Yana Victoria Avila
• Valeria Guadalupe Avina Garcia

• Clinical Medical Laboratory in Woodland Hills, CA
• Providers in Woodland Hills, 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 Nov 7, 2016; 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.