Provider Demographics
NPI:1215095609
Name:WORLD DIAGNOSTICS MEDICAL GROUP
Entity type:Organization
Organization Name:WORLD DIAGNOSTICS MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:ASHER
Authorized Official - Last Name:YAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-967-3309
Mailing Address - Street 1:PO BOX 67960
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-0960
Mailing Address - Country:US
Mailing Address - Phone:800-967-3309
Mailing Address - Fax:800-967-1138
Practice Address - Street 1:11845 W OLYMPIC BLVD
Practice Address - Street 2:STE 520W
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1149
Practice Address - Country:US
Practice Address - Phone:800-967-3309
Practice Address - Fax:800-967-1138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Not Answered2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty