Provider Demographics
NPI:1366495392
Name:VS DIAGNOSTIC, INC
Entity Type:Organization
Organization Name:VS DIAGNOSTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VADIM
Authorized Official - Middle Name:
Authorized Official - Last Name:VARTANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-252-0875
Mailing Address - Street 1:14621 TITUS ST
Mailing Address - Street 2:SUITE 225
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-4905
Mailing Address - Country:US
Mailing Address - Phone:323-252-0875
Mailing Address - Fax:818-997-8676
Practice Address - Street 1:14621 TITUS ST
Practice Address - Street 2:SUITE 225
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4905
Practice Address - Country:US
Practice Address - Phone:323-252-0875
Practice Address - Fax:818-997-8676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATG 409Medicare ID - Type UnspecifiedIDTF