Healthcare Provider Details

I. General information

NPI: 1104439652
Provider Name (Legal Business Name): CALIFORNIA RADIOLOGY MANAGEMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2020
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 W COLORADO ST STE 2
GLENDALE CA
91204-1670
US

IV. Provider business mailing address

20011 VENTURA BLVD # 1002
WOODLAND HILLS CA
91364-2573
US

V. Phone/Fax

Practice location:
  • Phone: 818-708-6163
  • Fax: 818-340-5537
Mailing address:
  • Phone: 818-708-6163
  • Fax: 818-340-5537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAY SALARI
Title or Position: MEDICAL DIRECTOR
Credential: M.D
Phone: 818-708-6163