Provider Demographics
NPI:1801842430
Name:P & A DIAGNOSTIC SERVICES CORP
Entity Type:Organization
Organization Name:P & A DIAGNOSTIC SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:POGOS
Authorized Official - Middle Name:
Authorized Official - Last Name:POGOSJANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-449-9099
Mailing Address - Street 1:2500 E FOOTHILL BLVD
Mailing Address - Street 2:SUITE 408
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3464
Mailing Address - Country:US
Mailing Address - Phone:626-449-9099
Mailing Address - Fax:
Practice Address - Street 1:2500 E FOOTHILL BLVD
Practice Address - Street 2:SUITE 408
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3464
Practice Address - Country:US
Practice Address - Phone:626-449-9099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26594142471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATG519Medicare ID - Type UnspecifiedIDTF