Provider Demographics
NPI:1336458843
Name:BODY DIAGNOSTIC IMAGING
Entity Type:Organization
Organization Name:BODY DIAGNOSTIC IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NADERI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:213-389-7900
Mailing Address - Street 1:3875 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 411
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-3205
Mailing Address - Country:US
Mailing Address - Phone:213-389-7900
Mailing Address - Fax:213-389-7600
Practice Address - Street 1:3875 WILSHIRE BLVD
Practice Address - Street 2:SUITE 411
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-3205
Practice Address - Country:US
Practice Address - Phone:213-389-7900
Practice Address - Fax:213-389-7600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology