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General NPI Number Information
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NPI Number | 1396087060
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Entity Type | Organization
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Legal Business Name | MID-VALLEY IMAGING, LLC
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Dates
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Enumeration Date | 03/20/2013
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Last Update Date | 05/15/2015
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Provider Practice Location Address
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Address Line | 6303 OWENSMOUTH AVENUE, FL 10
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City | LOS ANGELES
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State | CA
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Zip | 91367-2263
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Country | US
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Telephone | 818-306-5597
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Fax | 800-900-4118
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Provider Business Mailing Address
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Address Line | 14622 VENTURA BLVD. #725
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-3600
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Country | US
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Telephone | 818-306-5597
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Fax | 866-415-9481
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MATT SABRKHANI
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Credential |
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Telephone | 818-294-7266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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