Lifescan Diagnostic Corp

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

LIFESCAN DIAGNOSTIC CORP

Practice address

3628 Lynoak Dr
Suite 105
Claremont, CA 91711-3243

Phone

(213) 298-9645

NPI assigned

Mar 1, 2023

Organization subpart

No

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

Authorized official

Name

Petros Patatanian

Title

Ceo

Phone

(213) 298-9645

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

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

{
    "created_epoch": "1677628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686787200000",
    "number": "1821797630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2863 95TH ST STE 143-159",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605649005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3628 LYNOAK DR",
            "address_2": "SUITE 105",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917113243",
            "telephone_number": "213-298-9645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESCAN DIAGNOSTIC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-01",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A",
        "authorized_official_last_name": "PATATANIAN",
        "authorized_official_first_name": "PETROS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "213-298-9645"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maurice Adam Levy, PH.D.
• Wilson Lew, PHARM D
• Michael Riess Lewin, PH.D.
• Caren Li Sun
• Miao Li, PHD
• Kathy Lindenmayer, NP
• Mary Therese Lindsey, LMFT
• Hao Cheng Liu
• Teri Llop, DDS
• Annette L Lobato

• Radiology Clinic/Center in Claremont, CA
• Providers in Claremont, CA by specialty
• Radiology Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; 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.