Provider Demographics
NPI:1700835766
Name:SHARP DIAGNOSTIC,INC.
Entity Type:Organization
Organization Name:SHARP DIAGNOSTIC,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTUR
Authorized Official - Middle Name:NONE
Authorized Official - Last Name:YANUKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-988-8626
Mailing Address - Street 1:13746 VICTORY BLVD
Mailing Address - Street 2:SUITE#209
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-6716
Mailing Address - Country:US
Mailing Address - Phone:818-988-8626
Mailing Address - Fax:818-988-8682
Practice Address - Street 1:13746 VICTORY BLVD
Practice Address - Street 2:SUITE#209
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-6716
Practice Address - Country:US
Practice Address - Phone:818-988-8626
Practice Address - Fax:818-988-8682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATG496Medicare ID - Type UnspecifiedI.D.T.F.