Provider Demographics
NPI:1467696211
Name:SYNDICATED DIAGNOSTIC IMAGING, INC.
Entity Type:Organization
Organization Name:SYNDICATED DIAGNOSTIC IMAGING, INC.
Other - Org Name:SPECIALTY IMAGING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KHACHATUR
Authorized Official - Middle Name:
Authorized Official - Last Name:POGOSYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-336-1775
Mailing Address - Street 1:PO BOX 250370
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91225-0370
Mailing Address - Country:US
Mailing Address - Phone:818-291-0547
Mailing Address - Fax:877-711-1421
Practice Address - Street 1:424 W BROADWAY
Practice Address - Street 2:100
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-1209
Practice Address - Country:US
Practice Address - Phone:818-502-0593
Practice Address - Fax:818-502-1061
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SYNDICATED DIAGNOSTIC IMAGING, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-04-23
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)