1952891251 NPI number — ALL STAR IMAGING

Table of content: DR. JAMES BERNARD WEEDMAN M.D. (NPI 1376796037)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952891251 NPI number — ALL STAR IMAGING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALL STAR IMAGING
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:
Provider Other Organization Name Type Code:
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:
1952891251
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/14/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1451 E CHEVY CHASE DR STE 102
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLENDALE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91206-4056
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1451 E CHEVY CHASE DR
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
GLENDALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-649-1801
Provider Business Practice Location Address Fax Number:
818-649-1805
Provider Enumeration Date:
05/14/2018

Additional Information

Authorized Official

Authorized Official Last Name:
KHOSHORYAN
Authorized Official First Name:
STEPAN
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
818-649-1801

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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