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General NPI Number Information
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NPI Number | 1457547663
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Entity Type | Organization
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Legal Business Name | M.R.DIAGNOSTIC IMAGING, INC
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Dates
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Enumeration Date | 09/20/2007
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Last Update Date | 09/20/2007
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Provider Practice Location Address
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Address Line | 116 N SWALL DR APT 202
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-1926
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Country | US
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Telephone | 310-659-1303
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Fax | 818-888-1544
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Provider Business Mailing Address
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Address Line | 116 N SWALL DR APT 202
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-1926
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Country | US
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Telephone | 310-659-1303
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Fax | 818-888-1544
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Authorized Official
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Title or Position | OWNER
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Name | LILIYAN PEPPER
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Credential |
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Telephone | 310-659-1303
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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 |
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License Number State |
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