Healthcare Provider Details

I. General information

NPI: 1578527339
Provider Name (Legal Business Name): PROHEALTH ADVANCED IMAGING INSTITUTE, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 01/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7345 MEDICAL CENTER DR SUITE 130
WEST HILLS CA
91307-1910
US

IV. Provider business mailing address

7345 MEDICAL CENTER DR SUITE 130
WEST HILLS CA
91307-1910
US

V. Phone/Fax

Practice location:
  • Phone: 818-710-6011
  • Fax: 818-456-5039
Mailing address:
  • Phone: 818-710-6011
  • Fax: 818-456-5039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: DR. PAYAM KASHFIAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 818-710-6011