Dynamic Clinical Laboratories, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

05D1045035 Issued in CA

Legal business name

DYNAMIC CLINICAL LABORATORIES, INC.

Practice address

516 N Larchmont Blvd
Los Angeles, CA 90004-1306

Phone

(800) 595-6976

Fax

(213) 402-3015

NPI assigned

Sep 28, 2015

Organization subpart

No

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

Authorized official

Name

Sean Ebrahimian

Title

Owner

Phone

(213) 595-1000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1443398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479168000000",
    "number": "1851761282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 N LARCHMONT BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900041306",
            "telephone_number": "800-595-6976",
            "fax_number": "213-402-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 N LARCHMONT BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900041306",
            "telephone_number": "800-595-6976",
            "fax_number": "213-402-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC CLINICAL LABORATORIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-28",
        "last_updated": "2016-11-15",
        "status": "A",
        "authorized_official_last_name": "EBRAHIMIAN",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "213-595-1000"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "05D1045035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerrit Dykstra
• Jeremy Branden Dyla
• Jacquelyn M Dylla
• Romana Popara Dymkoski, D.O.
• Alexander Mitchell Dymond
• Dynamic Health Labs
• Dynamic Interpreting LLC
• Dynamics Orthotics & Prosthetics, Inc.
• Dynamics Walkagain Rehab Inc.
• Dynasty Care Home Health, Inc.

• 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 Nov 15, 2016; 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.