Healthcare Provider Details

I. General information

NPI: 1710905617
Provider Name (Legal Business Name): NUCLEAR DIAGNOSTIC IMAGING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5995 TOPANGA CANYON BLVD
WOODLAND HILLS CA
91367-3623
US

IV. Provider business mailing address

5995 TOPANGA CANYON BLVD
WOODLAND HILLS CA
91367-3623
US

V. Phone/Fax

Practice location:
  • Phone: 818-888-7009
  • Fax:
Mailing address:
  • Phone: 818-888-7009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number7277-19
License Number StateCA

VIII. Authorized Official

Name: ANNA ZARRIN
Title or Position: CEO
Credential:
Phone: 818-888-7009