Provider Demographics
NPI:1083044192
Name:OHNI CLINICAL SERVICES, INC
Entity Type:Organization
Organization Name:OHNI CLINICAL SERVICES, INC
Other - Org Name:OHNI IMAGING AND IE ANESTHESIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:GALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-657-0123
Mailing Address - Street 1:PO BOX 45345
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-0345
Mailing Address - Country:US
Mailing Address - Phone:310-657-0123
Mailing Address - Fax:310-657-0142
Practice Address - Street 1:8631 W 3RD ST
Practice Address - Street 2:SUITE 945E
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5901
Practice Address - Country:US
Practice Address - Phone:310-657-0123
Practice Address - Fax:310-657-0142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-26
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64640174400000X, 2085R0202X
CA070788207L00000X
CA21319235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty