Medical Science Laboratory Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

05D1082642 Issued in CA

Legal business name

MEDICAL SCIENCE LABORATORY INC

Practice address

432 S San Vicente Blvd Ste 200
Los Angeles, CA 90048-4192

Phone

(310) 360-0066

Fax

(310) 360-0302

NPI assigned

Sep 5, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Kambaksh Tavakoli, CHS

Title

President

Phone

(310) 360-0066

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1220572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237248000000",
    "number": "1801044508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 S SAN VICENTE BLVD STE 220",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900484183",
            "telephone_number": "310-360-0066",
            "fax_number": "310-360-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 S SAN VICENTE BLVD STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900484192",
            "telephone_number": "310-360-0066",
            "fax_number": "310-360-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL SCIENCE LABORATORY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-05",
        "last_updated": "2009-03-17",
        "status": "A",
        "authorized_official_last_name": "TAVAKOLI",
        "authorized_official_first_name": "KAMBAKSH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-360-0066",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CHS"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "05D1082642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Los Angeles, CA
• Providers in Los Angeles, 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 Mar 17, 2009; 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.