Healthcare Provider Details

I. General information

NPI: 1245271824
Provider Name (Legal Business Name): CALIFORNIA DIAGNOSTICS SERVICES RA INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3940 LAUREL CANYON BLVD
STUDIO CITY CA
91604-3709
US

IV. Provider business mailing address

3940 LAURAL CYN BLVD #836
STUDIO CITY CA
91604
US

V. Phone/Fax

Practice location:
  • Phone: 818-355-8666
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateCA

VIII. Authorized Official

Name: ROBERT BRODSKY
Title or Position: PRESIDENT
Credential:
Phone: 818-355-8666