MEDICARE: A G S DIAGNOSTIC SERVICES 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	2471C3402X	Radiography Radiologic Technologist

General Provider Information

NPI Number	:	1144259847
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A G S DIAGNOSTIC SERVICES INC

Provider Business Mailing Address
First Line	:	5455 WILSHIRE BLVD STE 2124
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-4201
Country	:	US
Telephone Number	:	323-988-4564
Fax Number	:

Provider Business Practice Location Address
First Line	:	5455 WILSHIRE BLVD STE 2124
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-4201
Country	:	US
Telephone Number	:	323-988-4564
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. SUREN AYRATPEYAN
Credential	:
Telephone Number	:	323-988-4564

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	08/22/2020

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