Provider Demographics
NPI:1063846012
Name:DELMAR MEDICAL IMAGING INC
Entity Type:Organization
Organization Name:DELMAR MEDICAL IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAVAD
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMADIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-382-2220
Mailing Address - Street 1:17530 VENTURA BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3818
Mailing Address - Country:US
Mailing Address - Phone:818-382-2220
Mailing Address - Fax:818-827-3480
Practice Address - Street 1:12264 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-3058
Practice Address - Country:US
Practice Address - Phone:818-382-2220
Practice Address - Fax:818-827-3480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)