NPIMap

Organization Active NPI

Hollywood Diagnostic Service

  • Physiological Laboratory
  • Los Angeles, CA
National Provider Identifier
1760475040
Registry record updated Jun 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
HOLLYWOOD DIAGNOSTIC SERVICE
Practice address
7080 Hollywood Blvd
Suite 820
Los Angeles, CA 90028-6906
Phone
(323) 463-7030
Fax
(323) 463-0106
NPI assigned
Aug 23, 2005
Last updated
Jun 27, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2017

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

Authorized official

Name
Vladimir Lifshits
Title
Administrator
Phone
(323) 463-7030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X NU Primary

Addresses

Primary practice location

7080 Hollywood Blvd
Suite 820
Los Angeles, CA 90028-6906

Mailing address

PO Box 17255
Encino, CA 91416-7255
Phone (323) 463-7030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040122001130 CA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 4688576341 Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

1800 N Highland Ave
Ste 411
Los Angeles, CA 90028
Phone (323) 463-7030

7080 Hollywood Blvd
Ste 820
Los Angeles, CA 90028
Phone (323) 463-7030

1288 N D St
Sn Bernrdno, CA 92405
Phone (909) 888-6602

Practitioners & affiliated clinicians

Practitioners 6

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": "1124755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498521600000",
    "number": "1760475040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17255",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914167255",
            "telephone_number": "323-463-7030",
            "fax_number": "323-463-0106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7080 HOLLYWOOD BLVD",
            "address_2": "SUITE 820",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900286906",
            "telephone_number": "323-463-7030",
            "fax_number": "323-463-0106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLYWOOD DIAGNOSTIC SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-23",
        "last_updated": "2017-06-27",
        "status": "A",
        "authorized_official_last_name": "LIFSHITS",
        "authorized_official_first_name": "VLADIMIR",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "323-463-7030"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2017; 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.