MEDICARE: HEALTH GUARD IMAGING INC

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	2085U0001X	Diagnostic Ultrasound Physician	TG428	CA

General Provider Information

NPI Number	:	1326088196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH GUARD IMAGING INC

Provider Business Mailing Address
First Line	:	12509 OXNARD ST
Second Line	:	213
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-4467
Country	:	US
Telephone Number	:	818-980-2169
Fax Number	:	818-980-2171

Provider Business Practice Location Address
First Line	:	12509 OXNARD ST
Second Line	:	213
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-4467
Country	:	US
Telephone Number	:	818-980-2169
Fax Number	:	818-980-2171

Authorized Official
Title or Position	:	CEO
Name	:	ROUBINA LOUSNIKIAN
Credential	:
Telephone Number	:	818-980-2169

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	08/22/2020

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