Provider Demographics
NPI:1790956308
Name:F&M RADIOLOGY MEDICAL CENTER INC
Entity Type:Organization
Organization Name:F&M RADIOLOGY MEDICAL CENTER INC
Other - Org Name:ENCINO URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BAHRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:TABIBIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-708-6163
Mailing Address - Street 1:PO BOX 49911
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-0911
Mailing Address - Country:US
Mailing Address - Phone:818-708-6163
Mailing Address - Fax:818-344-1390
Practice Address - Street 1:18065 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-3517
Practice Address - Country:US
Practice Address - Phone:818-708-6163
Practice Address - Fax:818-344-1390
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:F&M RADIOLOGY MEDICAL CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-22
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
146N00000X, 171100000X, 207Q00000X
CAA40559146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty