Provider Demographics
NPI:1003040189
Name:WILBUR IMAGING PARTNERS INC
Entity Type:Organization
Organization Name:WILBUR IMAGING PARTNERS INC
Other - Org Name:OZ RADIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:RASTEGAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-705-3200
Mailing Address - Street 1:6742 WINNETKA AVE
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-4348
Mailing Address - Country:US
Mailing Address - Phone:818-705-3200
Mailing Address - Fax:818-705-6999
Practice Address - Street 1:6742 WINNETKA AVE
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:CA
Practice Address - Zip Code:91306-4348
Practice Address - Country:US
Practice Address - Phone:818-705-3200
Practice Address - Fax:818-705-6999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology