Provider Demographics
NPI:1265637961
Name:CENTER FOR DIAGNOSTIC IMAGING LLC
Entity Type:Organization
Organization Name:CENTER FOR DIAGNOSTIC IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATNER
Authorized Official - Prefix:
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:JANJUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-933-1112
Mailing Address - Street 1:6200 WILSHIRE BLVD
Mailing Address - Street 2:101
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5801
Mailing Address - Country:US
Mailing Address - Phone:323-933-1112
Mailing Address - Fax:323-933-9994
Practice Address - Street 1:6200 WILSHIRE BLVD
Practice Address - Street 2:101
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5801
Practice Address - Country:US
Practice Address - Phone:323-933-1112
Practice Address - Fax:323-933-9994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty