Provider Demographics
NPI:1407220965
Name:AAG MEDCARE DIAGNOSTIC INC
Entity Type:Organization
Organization Name:AAG MEDCARE DIAGNOSTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ANICETO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-697-2880
Mailing Address - Street 1:13172 VAN NUYS BLVD
Mailing Address - Street 2:
Mailing Address - City:PACOIMA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-2572
Mailing Address - Country:US
Mailing Address - Phone:818-697-2880
Mailing Address - Fax:818-697-2880
Practice Address - Street 1:13172 VAN NUYS BLVD
Practice Address - Street 2:
Practice Address - City:PACOIMA
Practice Address - State:CA
Practice Address - Zip Code:91331-2572
Practice Address - Country:US
Practice Address - Phone:818-697-2880
Practice Address - Fax:818-697-2880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-20
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty