Provider Demographics
NPI:1154643062
Name:VALLEY MEDICAL DIAGNOSTIC CENTER INC.
Entity Type:Organization
Organization Name:VALLEY MEDICAL DIAGNOSTIC CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HAKOBYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-203-5687
Mailing Address - Street 1:14416 VICTORY BLVD STE 113
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-6254
Mailing Address - Country:US
Mailing Address - Phone:818-582-3978
Mailing Address - Fax:818-582-3982
Practice Address - Street 1:14416 VICTORY BLVD STE 113
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-6254
Practice Address - Country:US
Practice Address - Phone:818-582-3978
Practice Address - Fax:818-582-3982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-18
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty