NPIMap

Organization Active NPI

American Medical Diagnostic Lab

  • Clinical Medical Laboratory
  • Garden Grove, CA
National Provider Identifier
1750632550
Registry record updated Sep 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
AMERICAN MEDICAL DIAGNOSTIC LAB
Practice address
12665 Garden Grove Blvd #111
Garden Grove, CA 92843
Phone
(714) 636-0261
Fax
(714) 636-0263
NPI assigned
Sep 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2012

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

Authorized official

Name
Rahim Karjoo, MD
Title
Owner
Phone
(714) 636-0261

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

12665 Garden Grove Blvd #111
Garden Grove, CA 92843

Mailing address

12665 Garden Grove Blvd #111
Garden Grove, CA 92843
Phone (714) 636-0261

National Provider Directory

National Provider Directory
Tax ID family
American Medical Diagnostic Lab2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348099200000",
    "number": "1750632550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD #111",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "92843",
            "telephone_number": "714-636-0261",
            "fax_number": "714-636-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD #111",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "92843",
            "telephone_number": "714-636-0261",
            "fax_number": "714-636-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN MEDICAL DIAGNOSTIC LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-20",
        "last_updated": "2012-09-20",
        "status": "A",
        "authorized_official_last_name": "KARJOO",
        "authorized_official_first_name": "RAHIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-636-0261",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; 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.