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General NPI Number Information
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NPI Number | 1609147552
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Entity Type | Organization
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Legal Business Name | ROYAL MRI & MEDICAL CENTER INC
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Dates
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Enumeration Date | 01/24/2012
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Last Update Date | 01/24/2012
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Provider Practice Location Address
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Address Line | 16311 VENTURA BLVD STE 787
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City | ENCINO
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State | CA
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Zip | 91436-4329
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Country | US
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Telephone | 818-905-7323
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Fax | 818-783-6108
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Provider Business Mailing Address
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Address Line | 16311 VENTURA BLVD STE 787
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City | ENCINO
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State | CA
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Zip | 91436-4329
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Country | US
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Telephone | 818-905-7323
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Fax | 818-783-6108
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | HEDAYAT ED GOLCHEH
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Credential | M.D.
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Telephone | 818-905-7323
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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 | A040588
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License Number State | CA
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