Provider Demographics
NPI:1184234791
Name:RST MEDICAL INC
Entity type:Organization
Organization Name:RST MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PA-C
Authorized Official - Prefix:
Authorized Official - First Name:TALLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIROSSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:623-760-7740
Mailing Address - Street 1:12272 WILLOWBEND LN
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-5150
Mailing Address - Country:US
Mailing Address - Phone:623-760-7740
Mailing Address - Fax:
Practice Address - Street 1:18040 SHERMAN WAY STE 210
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4656
Practice Address - Country:US
Practice Address - Phone:818-796-2920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
No251F00000XAgenciesHome Infusion
No261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine