Provider Demographics
NPI:1780989384
Name:DIAGNOSTIC CARE INC
Entity type:Organization
Organization Name:DIAGNOSTIC CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAHRIAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GHODSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-914-9150
Mailing Address - Street 1:8635 W 3RD ST STE 1170W
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-6104
Mailing Address - Country:US
Mailing Address - Phone:310-854-3313
Mailing Address - Fax:310-691-8877
Practice Address - Street 1:8635 W 3RD ST STE 1170W
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-6104
Practice Address - Country:US
Practice Address - Phone:310-854-3313
Practice Address - Fax:310-691-8877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-13
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72696207RC0200X, 261QS1200X
COA72696207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty