Healthcare Provider Details

I. General information

NPI: 1083188767
Provider Name (Legal Business Name): MABEL IMAGING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2019
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

356 E OLIVE AVE STE 111
BURBANK CA
91502-1260
US

IV. Provider business mailing address

356 E OLIVE AVE STE 111
BURBANK CA
91502-1260
US

V. Phone/Fax

Practice location:
  • Phone: 818-861-7559
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State

VIII. Authorized Official

Name: PETROS PATATANIAN
Title or Position: CEO/PRESIDENT
Credential:
Phone: 818-861-7559