Healthcare Provider Details

I. General information

NPI: 1801842430
Provider Name (Legal Business Name): P & A DIAGNOSTIC SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 E FOOTHILL BLVD SUITE 408
PASADENA CA
91107-3464
US

IV. Provider business mailing address

2500 E FOOTHILL BLVD SUITE 408
PASADENA CA
91107-3464
US

V. Phone/Fax

Practice location:
  • Phone: 626-449-9099
  • Fax:
Mailing address:
  • Phone: 626-449-9099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number2659414
License Number StateCA

VIII. Authorized Official

Name: POGOS POGOSJANS
Title or Position: CEO
Credential:
Phone: 626-449-9099