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PHYSICIANS SERVICE LABORATORY NPI 1770667586


NPI Information

NPI: 1770667586
Provider Name: PHYSICIANS SERVICE LABORATORY
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
5101 E FLORENCE AVE
2
BELL, CA
ZIP 90201
Phone: (323) 560-1862
Get Directions

PHYSICIANS SERVICE LABORATORY is a diagnostic radiology radiology in Bell, CA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. PHYSICIANS SERVICE LABORATORY NPI is 1770667586. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5101 E FLORENCE AVE
2
BELL, CA
ZIP 90201-801
Phone: (323) 560-1862
Fax: (323) 560-7580

The provider's authorized official is Blaine L Montgomery .
The authorized official title is Supervising Radiologist and has the following contact phone number (323) 560-1862.

The enumeration date for this NPI number is 10/25/2006 and was last updated on 4/4/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085R0202XRadiologyDiagnostic RadiologyA28710CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1A83841MEDICARE UPIN
2TG244MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA
3222583422OTHERCALIFORNIABLUE SHIELD
400A287100MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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