MEDICARE: H AND M MANAGEMENT AND DIAGNOSTIC INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2471C3402X	Radiography Radiologic Technologist

General Provider Information

NPI Number	:	1124075726
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	H AND M MANAGEMENT AND DIAGNOSTIC INC

Provider Business Mailing Address
First Line	:	12840 RIVERSIDE DR
Second Line	:
City	:	VALLEY VILLAGE
State	:	CA
Zip	:	91607-3344
Country	:	US
Telephone Number	:	818-980-6500
Fax Number	:	818-760-4335

Provider Business Practice Location Address
First Line	:	12840 RIVERSIDE DR
Second Line	:
City	:	VALLEY VILLAGE
State	:	CA
Zip	:	91607-3327
Country	:	US
Telephone Number	:	818-980-6500
Fax Number	:	818-760-4335

Authorized Official
Title or Position	:	CEO
Name	:	MIGRAN PETROSYAN
Credential	:
Telephone Number	:	818-980-6500

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	08/12/2008

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