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General NPI Number Information
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NPI Number | 1851347272
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Entity Type | Organization
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Legal Business Name | PALMS IMAGING MEDICAL GROUP
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 12/03/2014
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Provider Practice Location Address
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Address Line | 1901 OUTLET CENTER DRIVE
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City | OXNARD
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State | CA
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Zip | 93036
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Country | US
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Telephone | 805-604-9500
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Fax | 805-604-9559
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Provider Business Mailing Address
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Address Line | PO BOX 190
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City | SIMI VALLEY
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State | CA
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Zip | 93062-0190
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Country | US
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Telephone | 805-522-5940
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Fax | 805-522-6401
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | BEHZAD NOORBEHESHT
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Credential | M.D.
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Telephone | 805-604-9500
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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 |
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License Number State |
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