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General NPI Number Information
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NPI Number | 1942169800
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Entity Type | Organization
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Legal Business Name | AVISINA WELLNESS IMAGING CORPORATION
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Dates
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Enumeration Date | 01/16/2026
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 17779 VENTURA BLVD # 100
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City | ENCINO
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State | CA
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Zip | 91316-3717
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Country | US
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Telephone | 818-708-6163
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Fax | 818-600-8417
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Provider Business Mailing Address
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Address Line | 17779 VENTURA BLVD # 100
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City | ENCINO
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State | CA
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Zip | 91316-3717
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Country | US
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Telephone | 818-708-6163
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Fax | 818-600-8417
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Authorized Official
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Title or Position | MANAGER
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Name | AREZOU KAMANDI
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Credential |
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Telephone | 818-708-6163
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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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 | 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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