| Wireless Diagnostic | |
|
2080 Century Park East #1206 Los Angeles CA 90067 | |
| (310) 282-0525 | |
| (310) 201-0662 |
| Full Name | Wireless Diagnostic |
|---|---|
| Speciality | Internal Medicine |
| Location | 2080 Century Park East #1206, Los Angeles, California |
| Authorized Official Name and Position | Nicholas Karyotakis (OWNER) |
| Authorized Official Contact | 3102820525 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wireless Diagnostic 9589 Stuart Lane Beverly Hills CA 90210 Ph: (310) 282-0525 | Wireless Diagnostic 2080 Century Park East #1206 Los Angeles CA 90067 Ph: (310) 282-0525 |
| NPI Number | 1821164070 |
|---|---|
| Provider Enumeration Date | 11/28/2006 |
| Last Update Date | 08/07/2015 |
| Medicare PECOS PAC ID | 2961716113 |
|---|---|
| Medicare Enrollment ID | O20150731014917 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821164070 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | A61044 (California) | Primary |
| Provider Name | Ellie Lekov |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1033266788 PECOS PAC ID: 1052444148 Enrollment ID: I20100726000616 |
| Provider Name | Nicholas Karyotakis |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1922072826 PECOS PAC ID: 0143260471 Enrollment ID: I20101115000450 |
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