NPIMap

Organization Active NPI

Anthony Bledin MD Inc

  • Clinical Medical Laboratory
  • Los Angeles, CA
National Provider Identifier
1861648164
Registry record updated Aug 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
C42124 Issued in CA
Legal business name
ANTHONY BLEDIN MD INC
Practice address
7301 S Western Ave
Los Angeles, CA 90047-2254
Phone
(323) 778-2131
Fax
(323) 778-2382
NPI assigned
Aug 18, 2008
Last updated
Aug 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2008

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

Authorized official

Name
Dr. Anthony G Bledin, MDNPI 1588687115
Title
Radiologist
Phone
(805) 494-9940

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X C42124 CA Primary

Addresses

Primary practice location

7301 S Western Ave
Los Angeles, CA 90047-2254

Mailing address

1851 Holser Walk Ste 220
Oxnard, CA 93036-2626
Phone (805) 988-1111

Other identifiers 1

IdentifierTypeStateIssuer
00C421240MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120524000478 CA Part B Supplier - Clinic/Group Practice 5890958110 Receives reassigned benefits from 1 practitioner
6 other NPIs on this enrollment
Practice locations: Granada Hills, CA; Los Angeles, CA; Montebello, CA; Oxnard, CA; Westlake Village, CA; Woodland Hills, CA

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Anthony Bledin MD Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1219017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219017600000",
    "number": "1861648164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 HOLSER WALK STE 220",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930362626",
            "telephone_number": "805-988-1111",
            "fax_number": "805-988-0254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 S WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900472254",
            "telephone_number": "323-778-2131",
            "fax_number": "323-778-2382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY BLEDIN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-18",
        "last_updated": "2008-08-18",
        "status": "A",
        "authorized_official_last_name": "BLEDIN",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "RADIOLOGIST",
        "authorized_official_telephone_number": "805-494-9940",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "C42124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C421240",
            "state": "CA"
        }
    ],
    "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 Aug 18, 2008; 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.