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General NPI Number Information
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NPI Number | 1962733923
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC CARE INC A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 01/14/2010
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Last Update Date | 01/14/2010
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Provider Practice Location Address
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Address Line | 8635 W 3RD ST SUITE 1170W
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City | LOS ANGELES
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State | CA
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Zip | 90048-6101
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Country | US
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Telephone | 310-854-3313
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Fax | 310-691-8877
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Provider Business Mailing Address
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Address Line | 8635 W 3RD ST SUITE 1170W
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City | LOS ANGELES
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State | CA
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Zip | 90048-6101
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Country | US
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Telephone | 310-854-3313
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Fax | 310-691-8877
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Authorized Official
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Title or Position | PHYSICIAN
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Name | SHAHRIAR GHODSIAN
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Credential | M.D.
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Telephone | 310-854-3313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | A72696
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | A72696
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number | A72696
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License Number State | CA
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