MEDICARE: HEALTH DIAGNOSTICS OF CALIFORNIA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0200X	Radiology Clinic/Center

General Provider Information

NPI Number	:	1003042235
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH DIAGNOSTICS OF CALIFORNIA LLC

Provider Business Mailing Address
First Line	:	PO BOX 203557
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75320-3557
Country	:	US
Telephone Number	:	888-685-3910
Fax Number	:	800-508-4751

Provider Business Practice Location Address
First Line	:	8370 WILSHIRE BLVD
Second Line	:	SUITE 110
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2333
Country	:	US
Telephone Number	:	323-966-0000
Fax Number	:	323-966-0064

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HOWARD SIMON
Credential	:	M.D.
Telephone Number	:	480-264-2400

Provider Enumeration Date	:	06/02/2009
Last Update Date	:	01/28/2013

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