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General NPI Number Information
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NPI Number | 1841432994
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Entity Type | Organization
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Legal Business Name | DYNAMIC DIAGNOSTIC IMAGING CENTER
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Dates
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Enumeration Date | 04/02/2009
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Last Update Date | 04/02/2009
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Provider Practice Location Address
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Address Line | 14532 FRIAR ST STE D
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City | VAN NUYS
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State | CA
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Zip | 91411-4715
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Country | US
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Telephone | 818-909-9696
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 19333
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City | ENCINO
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State | CA
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Zip | 91416-9333
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Country | US
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Telephone | 818-909-9696
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHAHRIAR S. RAD
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Credential | DC
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Telephone | 818-909-9696
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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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