Healthcare Provider Details

I. General information

NPI: 1538528666
Provider Name (Legal Business Name): PZY DIAGNOSTIC CONSULTING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2016
Last Update Date: 02/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2490 HONOLULU AVE , #128, UNIT B
MONTROSE CA
91020-1800
US

IV. Provider business mailing address

2490 HONOLULU AVE UNIT B
MONTROSE CA
91020-1800
US

V. Phone/Fax

Practice location:
  • Phone: 818-434-3237
  • Fax: 818-330-9963
Mailing address:
  • Phone: 818-434-3237
  • Fax: 818-330-9963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number105521
License Number StateCA

VIII. Authorized Official

Name: MR. PETER YUO
Title or Position: PRESIDENT
Credential:
Phone: 818-434-3237