Provider Demographics
NPI:1841556214
Name:STANDUP OPEN MRI CENTERS OF LA, LLC
Entity Type:Organization
Organization Name:STANDUP OPEN MRI CENTERS OF LA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MORTEZA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAMSNIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-885-3737
Mailing Address - Street 1:4349 LOVELAND ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-4121
Mailing Address - Country:US
Mailing Address - Phone:504-934-4000
Mailing Address - Fax:504-934-4001
Practice Address - Street 1:4349 LOVELAND ST.
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006
Practice Address - Country:US
Practice Address - Phone:504-934-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CP81Medicare UPIN