1003042235 NPI number — HEALTH DIAGNOSTICS OF CALIFORNIA LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003042235 NPI number — HEALTH DIAGNOSTICS OF CALIFORNIA LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH DIAGNOSTICS OF CALIFORNIA LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
STAND UP MRI OF BEVERLY HILLS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003042235
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/28/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 203557
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75320-3557
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-685-3910
Provider Business Mailing Address Fax Number:
800-508-4751

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8370 WILSHIRE BLVD
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
BEVERLY HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90211-2333
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-966-0000
Provider Business Practice Location Address Fax Number:
323-966-0064
Provider Enumeration Date:
06/02/2009

Additional Information

Authorized Official

Authorized Official Last Name:
SIMON
Authorized Official First Name:
HOWARD
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
480-264-2400

Provider Taxonomy Codes

  • Taxonomy code: 261QR0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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