Provider Demographics
NPI:1508027954
Name:WILSHIRE RADIOLOGY
Entity Type:Organization
Organization Name:WILSHIRE RADIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHLOMO
Authorized Official - Middle Name:
Authorized Official - Last Name:AMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-487-4077
Mailing Address - Street 1:3055 WILSHIRE BLVD
Mailing Address - Street 2:STE.150
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-1108
Mailing Address - Country:US
Mailing Address - Phone:213-487-4077
Mailing Address - Fax:213-487-7515
Practice Address - Street 1:3055 WILSHIRE BLVD
Practice Address - Street 2:STE.150
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-1108
Practice Address - Country:US
Practice Address - Phone:213-487-4077
Practice Address - Fax:213-487-7515
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUNTINGTON RADIOLOGY, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology