Provider Demographics
NPI:1730136169
Name:HEALTHSCAN DIAGNOSTICS,INC.
Entity Type:Organization
Organization Name:HEALTHSCAN DIAGNOSTICS,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGOMOLNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-866-2027
Mailing Address - Street 1:6363 WILSHIRE BLVD.#120
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048
Mailing Address - Country:US
Mailing Address - Phone:323-866-2027
Mailing Address - Fax:
Practice Address - Street 1:6363 WILSHIRE BLVD. #120
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048
Practice Address - Country:US
Practice Address - Phone:323-866-2027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATG 425Medicare ID - Type UnspecifiedMEDICAL DIAGNOSTIC SERVIC