MEDICARE: CALIFORNIA DIAGNOSTICS SERVICES RA INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory		CA

General Provider Information

NPI Number	:	1245271824
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALIFORNIA DIAGNOSTICS SERVICES RA INC.

Provider Business Mailing Address
First Line	:	3940 LAURAL CYN BLVD
Second Line	:	#836
City	:	STUDIO CITY
State	:	CA
Zip	:	91604
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3940 LAUREL CANYON BLVD
Second Line	:
City	:	STUDIO CITY
State	:	CA
Zip	:	91604-3709
Country	:	US
Telephone Number	:	818-355-8666
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROBERT BRODSKY
Credential	:
Telephone Number	:	818-355-8666

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	07/21/2022

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