Healthcare Provider Details
I. General information
NPI: 1881859205
Provider Name (Legal Business Name): SCHWARTZBERG DIAGNOSTIC MEDICAL IMAGING INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/24/2008
Last Update Date: 07/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16935 VANOWEN ST SUITE H
VAN NUYS CA
91406-4595
US
IV. Provider business mailing address
16935 VANOWEN ST SUITE H
VAN NUYS CA
91406-4595
US
V. Phone/Fax
- Phone: 818-342-0701
- Fax: 818-342-0702
- Phone: 818-342-0701
- Fax: 818-342-0702
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
IRVING
J
SCHWARTZ
Title or Position: CEO
Credential: MD
Phone: 818-342-0701