MEDICARE: ATLAS DIAGNOSTIC SERVICES,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	261QS1200X	Sleep Disorder Diagnostic Clinic/Center	TD068	CA

General Provider Information

NPI Number	:	1588769806
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLAS DIAGNOSTIC SERVICES,INC

Provider Business Mailing Address
First Line	:	3959 LAUREL CYN BL.
Second Line	:	STE 'C'
City	:	STUDIO CITY
State	:	CA
Zip	:	91604-3711
Country	:	US
Telephone Number	:	818-506-6663
Fax Number	:	818-506-2505

Provider Business Practice Location Address
First Line	:	3959 LAUREL CYN BL.
Second Line	:	STE 'C'
City	:	STUDIO CITY
State	:	CA
Zip	:	91604-3711
Country	:	US
Telephone Number	:	818-506-6663
Fax Number	:	818-506-2505

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. ANNA VISHNEVSKY
Credential	:
Telephone Number	:	818-506-6663

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	04/23/2010

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