Provider Demographics
NPI:1639411846
Name:CALIFORNIA MED-LEGAL IMAGING
Entity Type:Organization
Organization Name:CALIFORNIA MED-LEGAL IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SATTAR
Authorized Official - Middle Name:
Authorized Official - Last Name:MIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-905-6000
Mailing Address - Street 1:PO BOX 1071
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91209-1071
Mailing Address - Country:US
Mailing Address - Phone:818-905-6000
Mailing Address - Fax:818-905-6000
Practice Address - Street 1:9500 ARTESIA BLVD
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-6511
Practice Address - Country:US
Practice Address - Phone:562-867-6464
Practice Address - Fax:800-400-9118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13787261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)