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General NPI Number Information
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NPI Number | 1750670584
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Entity Type | Organization
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Legal Business Name | MAF IMAGING CENTER LLC
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Dates
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Enumeration Date | 04/01/2011
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Last Update Date | 04/01/2011
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Provider Practice Location Address
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Address Line | 1884 BUSINESS CENTER DR
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City | SAN BERNARDINO
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State | CA
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Zip | 92408-3457
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Country | US
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Telephone | 909-890-5552
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Fax | 909-890-5588
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Provider Business Mailing Address
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Address Line | PO BOX 49911
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City | LOS ANGELES
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State | CA
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Zip | 90049-0911
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Country | US
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Telephone | 310-481-0858
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Fax | 310-474-3416
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MOOSSA HEIKALI
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Credential | M.D
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Telephone | 310-481-0858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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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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