Healthcare Provider Details

I. General information

NPI: 1154763407
Provider Name (Legal Business Name): COMMUNITY HEALTH IMAGING CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2013
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4060 FAIRMOUNT AVE
SAN DIEGO CA
92105-1608
US

IV. Provider business mailing address

4060 FAIRMOUNT AVE
SAN DIEGO CA
92105-1608
US

V. Phone/Fax

Practice location:
  • Phone: 619-997-4859
  • Fax: 619-342-1698
Mailing address:
  • Phone: 619-997-4859
  • Fax: 619-342-1698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number239408
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QR0206X
TaxonomyMammography Clinic/Center
License Number81412111187
License Number StateCA

VIII. Authorized Official

Name: MR. ZARA MARSELIAN
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 619-584-1612