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General NPI Number Information
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NPI Number | 1841490257
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Entity Type | Organization
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Legal Business Name | HEALTH ALERT SCREENING AND DIAGNOSTIC IMAGING(HASDI) INC
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 5832 W SAN MIGUEL AVE SUITE#4
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City | GLENDALE
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State | AZ
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Zip | 85301-5907
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Country | US
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Telephone | 623-455-1219
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Fax |
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Provider Business Mailing Address
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Address Line | 5832 W SAN MIGUEL AVE SUITE#5
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City | GLENDALE
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State | AZ
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Zip | 85301-5907
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Country | US
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Telephone | 623-455-1219
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | JUSTIN FREDRIC WEISS
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Credential | M.D.
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Telephone | 520-247-1547
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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 | 9418
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License Number State | AZ
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