Healthcare Provider Details

I. General information

NPI: 1801571732
Provider Name (Legal Business Name): UNIVERSAL DIAGNOSTICS CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2023
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S GLENOAKS BLVD STE 415
BURBANK CA
91502-1474
US

IV. Provider business mailing address

601 S GLENOAKS BLVD STE 415
BURBANK CA
91502-1474
US

V. Phone/Fax

Practice location:
  • Phone: 747-283-1443
  • Fax: 747-283-1460
Mailing address:
  • Phone: 747-283-1443
  • Fax: 747-283-1460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: NAZARET VARDANYAN
Title or Position: CEO/OWNER
Credential:
Phone: 310-779-7042