Megamed Clinical Laboratories Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MEGAMED CLINICAL LABORATORIES INC

Practice address

7302 Canby Ave
Reseda, CA 91335-3010

Phone

(818) 654-0632

Fax

(818) 654-0634

NPI assigned

Oct 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Shapour Motamedi, PH.D.

Title

President

Phone

(818) 654-0632

Specialties & licenses 1

Addresses

Other identifiers 3

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": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410480000000",
    "number": "1992895643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7302 CANBY AVE",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913353010",
            "telephone_number": "818-654-0632",
            "fax_number": "818-654-0634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7302 CANBY AVE",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913353010",
            "telephone_number": "818-654-0632",
            "fax_number": "818-654-0634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEGAMED CLINICAL LABORATORIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2014-09-12",
        "status": "A",
        "authorized_official_last_name": "MOTAMEDI",
        "authorized_official_first_name": "SHAPOUR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-654-0632",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB69790G",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ64202Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "CLF011639",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Medical Staffing Network LLC
• Medical Support Los Angeles a Medical Corporation
• Mediserve LLC
• Medplus Healthcare Essentials Inc.
• Richard Thomas Meeks, M.A., MFT
• Nicolas Shane Mehis, D.O.
• Marmar Mehrpouyan, PSYD
• Sindy Membreno
• Martha Angelica Mena
• Alejandra Del Carmen Mendez-Carballo, MSW, ACSW

• Clinical Medical Laboratory in Reseda, CA
• Providers in Reseda, 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 Sep 12, 2014; 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.