Organization Active NPI

Pad Diagnostics Inc

  • General Practice Physician
  • Sunland, CA
National Provider Identifier
1750640967
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
PAD DIAGNOSTICS INC
Practice address
10823 Odell Ave
Sunland, CA 91040
Phone
(818) 875-4185
Fax
(818) 875-4195
NPI assigned
May 8, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Authorized official

Name
Arman Petrosian
Title
Ceo/President
Phone
(818) 547-5799

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary
Physiological Laboratory 293D00000X

Addresses

Primary practice location

10823 Odell Ave
Sunland, CA 91040

Mailing address

10823 Odell Ave
Sunland, CA 91040
Phone (818) 875-4185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140509000962 CA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 7911130380 Practice locations: Sunland, CA
O20210924002684 CA Part B Supplier - Portable X-Ray Supplier 7911130380 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sunland, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607040000000",
    "number": "1750640967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10823 ODELL AVE",
            "city": "SUNLAND",
            "state": "CA",
            "postal_code": "91040",
            "telephone_number": "818-875-4185",
            "fax_number": "818-875-4195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10823 ODELL AVE",
            "city": "SUNLAND",
            "state": "CA",
            "postal_code": "91040",
            "telephone_number": "818-875-4185",
            "fax_number": "818-875-4195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAD DIAGNOSTICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-08",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A",
        "authorized_official_last_name": "PETROSIAN",
        "authorized_official_first_name": "ARMAN",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "818-547-5799"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.