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General NPI Number Information
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NPI Number | 1508282401
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Entity Type | Organization
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Legal Business Name | PACIFIC IMAGING ENTERPRISES, INC.
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Dates
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Enumeration Date | 03/15/2014
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Last Update Date | 03/15/2014
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Provider Practice Location Address
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Address Line | 19231 VICTORY BLVD SUITE 153
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City | RESEDA
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State | CA
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Zip | 91335-6308
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Country | US
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Telephone | 818-654-6830
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Fax | 818-654-6834
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Provider Business Mailing Address
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Address Line | 19231 VICTORY BLVD SUITE 153
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City | RESEDA
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State | CA
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Zip | 91335-6308
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Country | US
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Telephone | 818-654-6830
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Fax | 818-654-6834
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Authorized Official
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Title or Position | CEO
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Name | MR. SAM S EKTEFAIE
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Credential |
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Telephone | 818-636-3455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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