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General NPI Number Information
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NPI Number | 1174740880
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Entity Type | Organization
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Legal Business Name | MEDNIK MEDICAL CORPORATION
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 8501 WILSHIRE BLVD STE 250
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-3101
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Country | US
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Telephone | 310-492-0613
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Fax | 310-289-0372
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Provider Business Mailing Address
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Address Line | 369 S DOHENY DR SUITE 210
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-3508
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GEORGE MEDNIK
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Credential | M.D., PH. D.
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Telephone | 310-492-0613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | A52346
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number | A52346
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License Number State | CA
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