MEDICARE: POWERFUL DIAGNOSTIC IMAGING

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	261QR0208X	Mobile Radiology Clinic/Center

General Provider Information

NPI Number	:	1770307985
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POWERFUL DIAGNOSTIC IMAGING

Provider Business Mailing Address
First Line	:	17149 CHATSWORTH ST APT 108
Second Line	:
City	:	GRANADA HILLS
State	:	CA
Zip	:	91344-5751
Country	:	US
Telephone Number	:	310-237-8424
Fax Number	:

Provider Business Practice Location Address
First Line	:	17149 CHATSWORTH ST APT 108
Second Line	:
City	:	GRANADA HILLS
State	:	CA
Zip	:	91344-5751
Country	:	US
Telephone Number	:	310-237-8424
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MAURICIO BATRES
Credential	:
Telephone Number	:	310-237-8424

Provider Enumeration Date	:	11/13/2024
Last Update Date	:	11/13/2024

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Directions to “POWERFUL DIAGNOSTIC IMAGING ” Practice Location

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