Healthcare Provider Details

I. General information

NPI: 1649361304
Provider Name (Legal Business Name): F&M RADIOLOGY MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20011 VENTURA BLVD
WOODLAND HILLS CA
91364-2573
US

IV. Provider business mailing address

P.O. BOX 49911
LOS ANGELES CA
90049-4911
US

V. Phone/Fax

Practice location:
  • Phone: 818-708-6163
  • Fax: 818-344-5537
Mailing address:
  • Phone: 818-708-6163
  • Fax: 818-344-1390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RAY SALARI
Title or Position: MEDICAL DIRECTOR
Credential: M.D
Phone: 818-708-6163