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NPI Code Detail

MEDICARE: NUCLEAR DIAGNOSTIC IMAGING LLC

MEDICARE: NUCLEAR DIAGNOSTIC IMAGING 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
12085R0202XDiagnostic Radiology Physician7277-19CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RADIOACTIVE MAT. LICOTHERCA7277-19

General Provider Information

NPI Number : 1710905617
Entity Type Code : Organization
Provider Name (Legal Business Name) : NUCLEAR DIAGNOSTIC IMAGING LLC
Provider Business Mailing Address
First Line : 5995 TOPANGA CANYON BLVD
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-3623
Country : US
Telephone Number : 818-888-7009
Fax Number :
Provider Business Practice Location Address
First Line : 5995 TOPANGA CANYON BLVD
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-3623
Country : US
Telephone Number : 818-888-7009
Fax Number :
Authorized Official
Title or Position : CEO
Name : ANNA ZARRIN
Credential :
Telephone Number : 818-888-7009
Provider Enumeration Date : 07/18/2006
Last Update Date : 08/22/2020

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Directions to “NUCLEAR DIAGNOSTIC IMAGING LLC ” Practice Location

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