Healthcare Provider Details

I. General information

NPI: 1699902197
Provider Name (Legal Business Name): VALLEY VASCULAR IMAGING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2009
Last Update Date: 06/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 S BUENA VISTA ST STE 300
BURBANK CA
91505-4569
US

IV. Provider business mailing address

PO BOX 16335
ENCINO CA
91416-6335
US

V. Phone/Fax

Practice location:
  • Phone: 818-558-7700
  • Fax: 818-558-7779
Mailing address:
  • Phone: 818-558-7700
  • Fax: 818-558-7779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471V0105X
TaxonomyVascular Sonography Radiologic Technologist
License NumberA64485
License Number StateCA

VIII. Authorized Official

Name: SASAN NAJIBI
Title or Position: PRESIDENT
Credential: MD
Phone: 818-558-7700