Provider Demographics
NPI:1396365011
Name:PRODIAGNOSE INC
Entity Type:Organization
Organization Name:PRODIAGNOSE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:REM
Authorized Official - Middle Name:
Authorized Official - Last Name:DARBINYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-528-1300
Mailing Address - Street 1:7345 TOPANGA CANYON BLVD # 210
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-1244
Mailing Address - Country:US
Mailing Address - Phone:323-528-1300
Mailing Address - Fax:818-357-5689
Practice Address - Street 1:7345 TOPANGA CANYON BLVD # 210
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1244
Practice Address - Country:US
Practice Address - Phone:323-528-1300
Practice Address - Fax:818-357-5689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty