Healthcare Provider Details

I. General information

NPI: 1265532659
Provider Name (Legal Business Name): ARRAY DIAGNOSTICS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 02/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 N. KEYSTONE ST. UNIT # B
BURBANK CA
91506
US

IV. Provider business mailing address

640 N KEYSTONE ST UNIT # B
BURBANK CA
91506-1900
US

V. Phone/Fax

Practice location:
  • Phone: 818-846-8666
  • Fax: 818-846-8665
Mailing address:
  • Phone: 818-846-8666
  • Fax: 818-846-8665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number StateNV
# 4
Primary TaxonomyY
Taxonomy Code225B00000X
TaxonomyPulmonary Function Technologist
License Number
License Number State

VIII. Authorized Official

Name: ANTON PAVLOV
Title or Position: CEO
Credential:
Phone: 818-846-8666