Healthcare Provider Details

I. General information

NPI: 1851347272
Provider Name (Legal Business Name): PALMS IMAGING MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 12/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 OUTLET CENTER DRIVE
OXNARD CA
93036
US

IV. Provider business mailing address

PO BOX 190
SIMI VALLEY CA
93062-0190
US

V. Phone/Fax

Practice location:
  • Phone: 805-604-9500
  • Fax: 805-604-9559
Mailing address:
  • Phone: 805-522-5940
  • Fax: 805-522-6401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: BEHZAD NOORBEHESHT
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 805-604-9500