Healthcare Provider Details

I. General information

NPI: 1194642009
Provider Name (Legal Business Name): LUCENT MEDICAL IMAGING, A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

647 W BROADWAY
GLENDALE CA
91204-1007
US

IV. Provider business mailing address

647 W BROADWAY
GLENDALE CA
91204-1007
US

V. Phone/Fax

Practice location:
  • Phone: 818-937-0047
  • Fax:
Mailing address:
  • Phone: 818-937-0047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0206X
TaxonomyMammography Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EDMOND KALANTAR OHANIAN
Title or Position: PRESIDENT
Credential: D.O.
Phone: 818-419-4321