MEDICARE: BEVERLY WILSHIRE MEDICAL IMAGING PC

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	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1518817634
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEVERLY WILSHIRE MEDICAL IMAGING PC

Provider Business Mailing Address
First Line	:	8530 WILSHIRE BLVD STE 200
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-3130
Country	:	US
Telephone Number	:	510-953-4099
Fax Number	:	510-792-7226

Provider Business Practice Location Address
First Line	:	8530 WILSHIRE BLVD STE 200
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-3130
Country	:	US
Telephone Number	:	510-714-5209
Fax Number	:	510-792-7226

Authorized Official
Title or Position	:	CONTRACTING ADMINISTRATOR
Name	:	CHEKAMEH KAZEROUNINIA
Credential	:
Telephone Number	:	510-714-5209

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	06/26/2026

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