MEDICARE: LEXINGTON HEALTH DIAGNOSTIC, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085U0001X	Diagnostic Ultrasound Physician

General Provider Information

NPI Number	:	1013928548
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEXINGTON HEALTH DIAGNOSTIC, INC.

Provider Business Mailing Address
First Line	:	PO BOX 4526
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91222-0526
Country	:	US
Telephone Number	:	626-356-9495
Fax Number	:	626-356-9431

Provider Business Practice Location Address
First Line	:	596 N LAKE AVE STE 200
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91101-1222
Country	:	US
Telephone Number	:	626-356-9495
Fax Number	:	626-356-9431

Authorized Official
Title or Position	:	CEO
Name	:	MR. KAREN MKHITARYAN
Credential	:
Telephone Number	:	626-356-9495

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	08/22/2020

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