Provider Demographics
NPI:1538103163
Name:MOBILE MRI SERVICES,INC.
Entity Type:Organization
Organization Name:MOBILE MRI SERVICES,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:VAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGOMOLNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-525-0865
Mailing Address - Street 1:6221 WILSHIRE BLVD.,
Mailing Address - Street 2:SUITE #LL1
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5022
Mailing Address - Country:US
Mailing Address - Phone:323-525-0865
Mailing Address - Fax:
Practice Address - Street 1:6221 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5222
Practice Address - Country:US
Practice Address - Phone:323-525-0865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty