Healthcare Provider Details

I. General information

NPI: 1003042235
Provider Name (Legal Business Name): HEALTH DIAGNOSTICS OF CALIFORNIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2009
Last Update Date: 01/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8370 WILSHIRE BLVD SUITE 110
BEVERLY HILLS CA
90211-2333
US

IV. Provider business mailing address

PO BOX 203557
DALLAS TX
75320-3557
US

V. Phone/Fax

Practice location:
  • Phone: 323-966-0000
  • Fax: 323-966-0064
Mailing address:
  • Phone: 888-685-3910
  • Fax: 800-508-4751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HOWARD SIMON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 480-264-2400