Provider Demographics
NPI:1477994796
Name:TOTAL DIAGNOSTIC CENTER
Entity type:Organization
Organization Name:TOTAL DIAGNOSTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDRANIK
Authorized Official - Middle Name:
Authorized Official - Last Name:TOVMASYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-624-3010
Mailing Address - Street 1:1052 SONORA AVE APT 24
Mailing Address - Street 2:APT 16
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-2453
Mailing Address - Country:US
Mailing Address - Phone:818-624-3010
Mailing Address - Fax:
Practice Address - Street 1:1052 SONORA AVE APT 24
Practice Address - Street 2:APT 16
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-2453
Practice Address - Country:US
Practice Address - Phone:818-624-3010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory