Lake Side Diagnostics Center, Inc.

LBN: Lake Side Diagnostics Center, Inc.
Lake Side Diagnostics Center, Inc. is an health care organization with primary practice located at 6908 Varna Ave , Valley Glen CA 91405-4358. The organization recently has 3 registered licenses in different health care specialties including Technologists, Technicians & Other Technical Service Providers / Sonography, Ambulatory Health Care Facilities / Radiology, Mobile, Laboratories / Physiological Laboratory. Ambulatory Health Care Facilities / Radiology, Mobile is the primary health care specialty. Lake Side Diagnostics Center, Inc. can be contacted via phone (818) 985-1999, or through Kanzburg, Yevgeny via phone (818) 985-1999.

Contact Information

Primary practice address
6908 Varna Ave Valley Glen CA 91405-4358
Phone: (818) 985-1999
Fax: (818) 985-1222
Website:
Map and Directions
Authorized official contact:
Name: Kanzburg, Yevgeny
Phone: (818) 985-1999

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Sonography 2471S1302X
Technologists, Technicians & Other Technical Service Providers / Sonography 2471S1302X California
Ambulatory Health Care Facilities / Radiology, Mobile 261QR0208X
Ambulatory Health Care Facilities / Radiology, Mobile 261QR0208X California
Laboratories / Physiological Laboratory 293D00000X
Laboratories / Physiological Laboratory 293D00000X California

Profile Details

NPI number 1558550129
LBN Legal business name Lake Side Diagnostics Center, Inc.
DBA Doing business as
Authorized official Kanzburg, Yevgeny
Entity Organization
Organization subpart 1 No
Enumeration date Oct 19th, 2007
Last updated Oct 26th, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558550129 NPPES
California MEDICAID 3311838

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