Healthcare Provider Details

I. General information

NPI: 1831214030
Provider Name (Legal Business Name): WESTWOOD OPEN MRI, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2112 E 4TH ST SUITE 220
SANTA ANA CA
92705-3816
US

IV. Provider business mailing address

10921 WILSHIRE BLVD MEZZANINE LEVEL
LOS ANGELES CA
90024-3906
US

V. Phone/Fax

Practice location:
  • Phone: 714-835-9080
  • Fax: 714-835-0114
Mailing address:
  • Phone: 310-208-3100
  • Fax: 310-208-3101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberG22691
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberG84712
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberG73373
License Number StateCA

VIII. Authorized Official

Name: DR. JERROLD MINK
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 310-208-3100