INNOVATIVE DIAGNOSTIC MEDICAL GROUP (NPI# 1013131796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013131796 |
| Entity Type | Organization |
| Organization Name | INNOVATIVE DIAGNOSTIC MEDICAL GROUP |
| Practice Address |
1801 Century Park East Suite 1040 Los Angeles CA 90067 |
| Practice Telephone | 3105537980 |
| Practice Fax Number | 3109433279 |
| Mailing Telephone | 3105537980 |
| Mailing Fax Number | 3109433279 |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2010-12-16 |
| Authorized Official Name | SEAN ATAEE (MEDICAL DIRECTOR/OWNER) |
| Authorized Official Telephone | 3105537960 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208100000X | Physical Medicine & Rehabilitation | A106704 | CA | Allopathic & Osteopathic Physicians |
| Y | 293D00000X | Physiological Laboratory | A44107 | CA | Laboratories |
| Street Address |
1801 CENTURY PARK EAST SUITE 1040 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90067 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518447028 | Shahrooz Saidian Dds Inc | Clinic/Center | 10231 Santa Monica Blvd Ste D, Los Angeles, CA 90067 | 2018-08-15 |
| 1467945758 | Braid Medical Corporation | Anesthesiology | 2080 Century Park E Ste 1111, Los Angeles, CA 90067 | 2018-06-11 |
| 1396233185 | Caroline Petrossian | Internal Medicine | 1880 Century Park East Suite 711, Century City, CA 90067 | 2018-04-26 |
| 1568860823 | Jaycee James | Naturopath | 2029 Century Park E, Los Angeles, CA 90067 | 2014-12-18 |
| 1437418803 | Ariella Aliza Morrow | Internal Medicine | 2080 Century Park E Ste 1605, Los Angeles, CA 90067 | 2012-05-04 |
| 1346524659 | Ben Shamoiel Chiropractic Inc | Chiropractor | 2080 Century Park East, Suite 503, Los Angeles, CA 90067 | 2011-10-05 |
| 1679709075 | Steven Kupferman Dmd Md Inc | Oral & Maxillofacial Surgery | 2080 Century Park East Blvd, Suite 710, Los Angeles, CA 90067 | 2009-06-01 |
| 1922214980 | Irwin Hoffman | Internal Medicine | 2298 Century Hill, Los Angeles, CA 90067 | 2007-05-15 |
| 1306068473 | David Hashimy Alexander | Obstetrics & Gynecology | 2080 Century Park E. #1206, Los Angeles, CA 90067 | 2007-05-02 |
| 1619191517 | Jeffrey A. Berman Md Inc | Orthopaedic Surgery | 2080 Century Park East # 305, Los Angeles, CA 90067 | 2007-04-12 |
| Find all providers in zip 90067 | ||||
| Taxonomy Code | 293D00000X |
| Grouping | Laboratories |
| Classification | Physiological Laboratory |
| A laboratory that operates independently of a hospital and physician’s office to furnish physiological diagnostic services (e.g. EEG’s , EKG’s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. |
| Notes: Source: Paraphrased from the Medicare Carrier Manual, Section 2070.5. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598238834 | Laboratory Environment LLC | Physiological Laboratory | 1436 S La Cienega Blvd Ste 208, Los Angeles, CA 90035-3761 | 2019-01-09 |
| 1194232272 | Harmony Diagnostics Inc | Physiological Laboratory | 11755 Wilshire Blvd Ste 1250, Los Angeles, CA 90025-1540 | 2018-01-10 |
| 1457862484 | Maria Susana Espino Gonzales | Physiological Laboratory | 5264 Lockhaven Ave, Los Angeles, CA 90041 | 2017-10-17 |
| 1700216256 | Greenline Diagnostics | Physiological Laboratory | 971 N La Cienega Blvd, Suite 202, Los Angeles, CA 90069-4790 | 2013-11-20 |
| 1326338823 | Krg Diagnostic Inc | Physiological Laboratory | 2404 Wilshire Blvd, Suite 5f, Los Angeles, CA 90057-3310 | 2011-04-18 |
| 1346401031 | Liber Diagnostics Inc | Physiological Laboratory | 1400 S Hayworth Ave, Suite 200, Los Angeles, CA 90035-4813 | 2008-06-24 |
| 1275794190 | Pulse Medical Diagnostics, Inc. | Physiological Laboratory | 11870 Santa Monica Blvd # 106-581, Los Angeles, CA 90025-2276 | 2008-06-23 |
| 1073642815 | Nsn Associates Inc | Physiological Laboratory | 3200 Wilshire Blvd, Suite 308, Los Angeles, CA 90010-1333 | 2007-03-05 |
| 1770633851 | Healthy Life Diagnostics, Inc. | Physiological Laboratory | 1930 Wilshire Blvd Ste 1209, Los Angeles, CA 90057-3622 | 2007-01-11 |
| 1144391947 | Ipb Medical Diagnostic, Inc. | Physiological Laboratory | 8939 S Sepulveda Bl, Suite 504, Los Angeles, CA 90045-3631 | 2006-11-13 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90067 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.