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General NPI Number Information
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NPI Number | 1487543385
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Entity Type | Organization
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Legal Business Name | LOS ANGELES BROADWAY RADIOLOGY PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 231 W VERNON AVE STE 111
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City | LOS ANGELES
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State | CA
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Zip | 90037-2778
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Country | US
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Telephone | 310-779-8907
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Fax |
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Provider Business Mailing Address
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Address Line | 231 W VERNON AVE STE 111
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City | LOS ANGELES
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State | CA
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Zip | 90037-2778
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Country | US
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Telephone | 310-779-8907
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. STUART STRAUSBERG
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Credential | DO
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Telephone | 310-779-8907
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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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