MEDICARE: LA MRI CENTER 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	2471M1202X	Magnetic Resonance Imaging Radiologic Technologist		CA

General Provider Information

NPI Number	:	1750534301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LA MRI CENTER INC.

Provider Business Mailing Address
First Line	:	4151 WEST 3RD STREET
Second Line	:	#B
City	:	LOS ANGELES
State	:	CA
Zip	:	90020
Country	:	US
Telephone Number	:	213-250-8822
Fax Number	:	213-250-8844

Provider Business Practice Location Address
First Line	:	4151 WEST 3RD STREET
Second Line	:	#B
City	:	LOS ANGELES
State	:	CA
Zip	:	90020
Country	:	US
Telephone Number	:	213-250-8822
Fax Number	:	213-250-8844

Authorized Official
Title or Position	:	OWNER
Name	:	MS. AKHTAR F GOLBAHAR
Credential	:
Telephone Number	:	213-250-8822

Provider Enumeration Date	:	10/28/2008
Last Update Date	:	08/05/2022

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