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General NPI Number Information
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NPI Number | 1144879198
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Entity Type | Organization
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Legal Business Name | SOUTHERN CALIFORNIA MEDICAL IMAGING AND OPEN MRI
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Dates
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Enumeration Date | 09/11/2019
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Last Update Date | 09/11/2019
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Provider Practice Location Address
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Address Line | 1809 VERDUGO BLVD STE 100
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City | GLENDALE
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State | CA
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Zip | 91208-1402
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Country | US
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Telephone | 818-790-9300
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Fax | 818-790-4564
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Provider Business Mailing Address
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Address Line | 4138 ELLENITA AVE
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City | TARZANA
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State | CA
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Zip | 91356-5418
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Country | US
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Telephone | 818-518-4606
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BOBAK KARDAN
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Credential |
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Telephone | 818-854-4890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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