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General NPI Number Information
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NPI Number | 1346335403
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Entity Type | Organization
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Legal Business Name | CENTRAL DIAGNOSTIC IMAGING NETWORK
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1220 S CENTRAL AVE #204
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City | GLANDALE
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State | CA
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Zip | 91204
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Country | US
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Telephone | 818-548-8333
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Fax | 818-548-7888
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Provider Business Mailing Address
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Address Line | 1220 S CENTRAL AVE #204
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City | GLENDALE
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State | CA
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Zip | 91204
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Country | US
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Telephone | 818-548-8333
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Fax | 818-548-7888
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Authorized Official
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Title or Position | PRESIDENT
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Name | MAURICE J HALE
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Credential | MD
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Telephone | 818-548-8333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | G84687
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License Number State | CA
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