Healthcare Provider Details

I. General information

NPI: 1942845607
Provider Name (Legal Business Name): HD DIAGNOSTIC IMAGING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2019
Last Update Date: 11/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4740 LOS FELIZ BLVD
LOS ANGELES CA
90027-1918
US

IV. Provider business mailing address

4740 LOS FELIZ BLVD
LOS ANGELES CA
90027-1918
US

V. Phone/Fax

Practice location:
  • Phone: 323-806-6670
  • Fax:
Mailing address:
  • Phone: 323-806-6670
  • 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: GREGORY BARSOM
Title or Position: DIRECTOR OF OPERATIONS
Credential: RVT
Phone: 323-806-6670