Healthcare Provider Details

I. General information

NPI: 1811228026
Provider Name (Legal Business Name): F&M RADIOLOGY MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2010
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1884 BUSINESS CENTER DRIVE
SAN BERNARDINO CA
92408-3457
US

IV. Provider business mailing address

20011 VENTURA BLVD 1002
WOODLAND HILLS CA
91364
US

V. Phone/Fax

Practice location:
  • Phone: 909-890-5552
  • Fax: 909-890-5588
Mailing address:
  • Phone: 818-708-6163
  • Fax: 818-340-5537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RAY SALARI
Title or Position: MEDICAL DIRECTOR
Credential: M.D
Phone: 818-708-6163