Provider Demographics
NPI:1780201012
Name:WHITSETT DIAGNOSTIC INC
Entity Type:Organization
Organization Name:WHITSETT DIAGNOSTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ELITA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOVHANNISIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-256-5460
Mailing Address - Street 1:12444 VICTORY BLVD STE 407
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3199
Mailing Address - Country:US
Mailing Address - Phone:818-210-7784
Mailing Address - Fax:
Practice Address - Street 1:12444 VICTORY BLVD STE 407
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3199
Practice Address - Country:US
Practice Address - Phone:818-210-7784
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-02
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology