Healthcare Provider Details

I. General information

NPI: 1912530635
Provider Name (Legal Business Name): VL SCAN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2020
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14545 FRIAR ST STE 131
VAN NUYS CA
91411-2397
US

IV. Provider business mailing address

14545 FRIAR ST STE 131
VAN NUYS CA
91411-2397
US

V. Phone/Fax

Practice location:
  • Phone: 818-223-7170
  • Fax:
Mailing address:
  • Phone: 818-223-7170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VILEN MANVELYAN
Title or Position: CEO
Credential:
Phone: 818-223-7170