Healthcare Provider Details

I. General information

NPI: 1013052109
Provider Name (Legal Business Name): HI IMAGING MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 N CENTRAL AVE STE 100
GLENDALE CA
91203-3355
US

IV. Provider business mailing address

540 N CENTRAL AVE STE 100
GLENDALE CA
91203-3355
US

V. Phone/Fax

Practice location:
  • Phone: 818-242-5588
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License NumberA41801
License Number StateCA

VIII. Authorized Official

Name: DR. MEHDI MASSIH
Title or Position: RADIOLOGIST
Credential: M.D.
Phone: 818-242-5588