FIDELIS DIAGNOSTICS, INC. (NPI# 1962460071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962460071 |
| Entity Type | Organization |
| Organization Name | FIDELIS DIAGNOSTICS, INC. |
| Practice Address |
11601 Wilshire Blvd Suite 500 Los Angeles CA 90025-0509 |
| Practice Telephone | 8774082488 |
| Practice Fax Number | 8667766641 |
| Mailing Telephone | 8774082488 |
| Mailing Fax Number | 8667766641 |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2007-07-17 |
| Authorized Official Name | MARK DORNER (COO) |
| Authorized Official Telephone | 8774082488 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZE0600X |
Specialist/Technologist, Other Specialization: Electroneurodiagnostic |
Technologists, Technicians & Other Technical Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | FIDELIS DIAGNOSTICS, INC. | 11706 Darlington Avenue, Los Angeles, California 90049 |
| Street Address |
11601 WILSHIRE BLVD SUITE 500 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90025-0509 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154928406 | Behavior Care Specialists, Inc | Assistant Behavior Analyst | 11601 Wilshire Blvd, Los Angeles, CA 90025-0509 | 2020-10-08 |
| 1770970238 | Hamila Mossadeghi | Clinic/Center | 11601 Wilshire Blvd, 500, Los Angeles, CA 90025-0509 | 2015-04-22 |
| 1588917322 | California Interventional Medical Group | Phlebology | 11601 Wilshire Blvd, 5th Floor, Los Angeles, CA 99025 | 2012-10-17 |
| 1538298351 | Ceth Ashen | Psychologist | 11601 Wilshire Blvd, 2410, Los Angeles, CA 90025-0509 | 2007-03-05 |
| 1336219526 | Sung Hwan Bae | Physical Therapist | 11601 Wilshire Blvd, Ste 105, Los Angeles, CA 90025-0509 | 2006-11-08 |
| 1306941158 | Carolyn Robertson | Registered Nurse | 11601 Wilshire Blvd, 5th Floor, Los Angeles, CA 90025-0509 | 2006-09-14 |
| 1841204484 | Ethan Ezaki | Physical Therapist | 11601 Wilshire Blvd, Los Angeles, CA 90025-0509 | 2006-07-28 |
| 1467403709 | Physiotherapy Associates Inc | Clinic/Center | 11601 Wilshire Blvd, Ste 105, Los Angeles, CA 90025-1700 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962324 | Marjan-marcia Khalitchi-alavi | Psychologist | 12400 Wilshire Blvd #230, Los Angeles, CA 90025 | 2020-11-06 |
| 1245852599 | Maureen Bridget Mcglynn | Marriage & Family Therapist | 1531 Purdue Avenue, Los Angeles, CA 90025 | 2020-05-09 |
| 1578118857 | Gregory J Bogie | Physical Therapist | 10351 Santa Monica Blvd. Suite 101, Los Angeles, CA 90025 | 2019-08-05 |
| 1518527712 | David Allen Goldstein | Marriage & Family Therapist | 12301 Wilshire Blvd., Suite 515, Los Angeles, CA 90025 | 2019-06-19 |
| 1386104875 | Kevin Meir Youssefzadeh | Student in an Organized Health Care Education/Training Program | 304 Dowlen Dr, Los Angeles, CA 90025 | 2019-03-21 |
| 1336609189 | Psychotherapy Center for Healing and Personal Growth | Psychologist | 2001 S. Barington Ave Suite 222, Los Angeles, CA 90025 | 2019-03-20 |
| 1477028819 | Flora Ma | Nurse Practitioner | 1726 Purdue Ave, Apt 2, Los Angeles, CA 90025 | 2018-10-12 |
| 1457834285 | Yeesul Yoo | Chiropractor | 2001 S. Barrington Ave Suite 101, Los Angeles, CA 90025 | 2018-09-07 |
| 1902387160 | Angelica Carmen Regalado | Behavior Technician | 7400 Pacific Blvd. Suite A & B, Walnut Park, CA 90025 | 2018-08-26 |
| 1033603378 | Craig Allen Gillett | Marriage & Family Therapist | 11847 Wilshire Blvd., #300, Los Angeles, CA 90025 | 2018-06-20 |
| Find all providers in zip 90025 | ||||
| Taxonomy Code | 246ZE0600X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Electroneurodiagnostic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659996296 | Kelly Olivia Brand | Specialist/Technologist, Other | 11044 Tennessee Ave, Los Angeles, CA 90064-1966 | 2020-06-09 |
| 1831119635 | Nsn Associates, Inc | Specialist/Technologist, Other | 3200 Wilshire Blvd Ste 308, Los Angeles, CA 90010-1307 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417576901 | Alpha Neuro-monitoring, LLC | Specialist/Technologist, Other | 751 E Blithedale Ave # 369, Mill Valley, CA 94941-1515 | 2020-04-14 |
| 1386276624 | Pinpoint Monitoring LLC | Specialist/Technologist, Other | 73521 Jameson Rd, Palm Desert, CA 92211-2031 | 2020-02-05 |
| 1255986329 | Hope Diagnostics Inc | Specialist/Technologist, Other | 10999 Riverside Dr 204, North Hollywood, CA 91602-2239 | 2019-08-06 |
| 1982267001 | California Diagnostic Specialists, Inc. | Specialist/Technologist, Other | 9191 Westminster Ave # 209, Garden Grove, CA 92844-2751 | 2019-04-15 |
| 1083174213 | Svetlana Almeida | Specialist/Technologist, Other | 28201 La Plumosa, Laguna Niguel, CA 92677-7049 | 2019-03-22 |
| 1629535604 | Diego Bautista | Specialist/Technologist, Other | 324 S Beverly Drive #214, Beverely Hills, CA 90212 | 2019-02-26 |
| 1184191256 | Satellite Medical LLC | Specialist/Technologist, Other | 3478 Buskirk Ave Ste 140, Pleasant Hill, CA 94523-4383 | 2018-10-26 |
| 1063994879 | Martin Phan | Specialist/Technologist, Other | 2995 Edison Dr, San Jose, CA 95133-2412 | 2018-08-29 |
| 1285123588 | Vincent Mattiello | Specialist/Technologist, Other | 13924 Marquesas Way Apt 2302, Marina Del Rey, CA 90292-6020 | 2018-05-02 |
| 1013418011 | Julie Bloomfield | Specialist/Technologist, Other | 6645 Elegant Tern Pl, Carlsbad, CA 92011-2640 | 2018-02-24 |
| Find all providers with the same taxonomy | ||||
| City | LOS ANGELES |
| Zip Code | 90025 |
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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.