LAKE SIDE DIAGNOSTICS CENTER, INC.
NPI 1558550129
Clinic/Center - Radiology, Mobile in Valley Glen, CA

Q: What is Lake Side Diagnostics Center, Inc.'s NPI number?

The NPI number for Lake Side Diagnostics Center, Inc. is 1558550129. It was assigned to this organization in the NPPES registry on October 19, 2007.

Q: What is Lake Side Diagnostics Center, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Radiology, Mobile, with taxonomy code 261QR0208X.

Active since October 19, 2007

6908 VARNA AVE, VALLEY GLEN, CA 91405(818) 985-1999(818) 985-1222 Get Directions Write a Review

NPPES record last updated: October 26, 2022. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Oct 26, 2022, Oct 15, 2021 (2 updates tracked since 2021).

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About Lake Side Diagnostics Center, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE SIDE DIAGNOSTICS CENTER, INC. (NPI 1558550129) is a healthcare organization registered as a radiology, mobile in Valley Glen, California and active in the NPI registry since October 2007. The organization lists Yevgeny Kanzburg, President, as its authorized official.

NPPES Registry Identity

NPI1558550129

Entity TypeOrganization

Primary Taxonomy261QR0208X

Legal Business NameLAKE SIDE DIAGNOSTICS CENTER, INC.

Location Address6908 VARNA AVEValley Glen, CA 91405-4358

Mailing Address6908 Varna AveValley Glen, CA 91405-4358 · (818) 985-1999 · Fax (818) 985-1222

Phone(818) 985-1999

Fax(818) 985-1222

Organization SubpartNo

Authorized OfficialYevgeny KanzburgPresident · (818) 985-1999

Enumeration DateOctober 19, 2007

Last NPPES UpdateOctober 26, 20222 updates tracked since enumeration

NPPES CertifiedOctober 26, 2022

✔ NPI 1558550129 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Radiology, MobileAmbulatory Health Care Facilities

Taxonomy Code261QR0208X

Also ListedRadiologic Technologist · SonographyTaxonomy 2471S1302X

Also ListedPhysiological LaboratoryTaxonomy 293D00000X

6908 VARNA AVE, Valley Glen, CA 91405

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Other Identifiers 1

Medicaid3311838CA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lake Side Diagnostics Center, Inc.'s NPI number?

The NPI number for Lake Side Diagnostics Center, Inc. is 1558550129. It was assigned to this organization in the NPPES registry on October 19, 2007.

Where is Lake Side Diagnostics Center, Inc. located?

Lake Side Diagnostics Center, Inc. is located at 6908 Varna Ave, Valley Glen, CA 91405. The listed phone number is (818) 985-1999.

What is Lake Side Diagnostics Center, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Radiology, Mobile, with taxonomy code 261QR0208X.

When was this NPI record last updated?

The NPPES record for Lake Side Diagnostics Center, Inc. was last updated on October 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.