MEDICARE: ACCESS 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
1	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center

General Provider Information

NPI Number	:	1922495167
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCESS IMAGING, LLC

Provider Business Mailing Address
First Line	:	350 N GLENDALE AVE
Second Line	:	505
City	:	GLENDALE
State	:	CA
Zip	:	91206-3794
Country	:	US
Telephone Number	:	747-444-5443
Fax Number	:

Provider Business Practice Location Address
First Line	:	4911 VAN NUYS BLVD
Second Line	:	103
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91403-1716
Country	:	US
Telephone Number	:	747-444-5443
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT OPERATIONS
Name	:	SATTAR MIR
Credential	:
Telephone Number	:	818-644-0046

Provider Enumeration Date	:	04/24/2015
Last Update Date	:	04/24/2015

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