Provider Demographics
NPI:1891761540
Name:INSIGHT HEALTH CORP
Entity Type:Organization
Organization Name:INSIGHT HEALTH CORP
Other - Org Name:OPEN MRI OF ENCINO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR V.P. & CHIEF ACCOUNTING OFCR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:DRAZBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-282-6000
Mailing Address - Street 1:FILE 57212
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-7212
Mailing Address - Country:US
Mailing Address - Phone:949-282-6000
Mailing Address - Fax:
Practice Address - Street 1:17323 VENTURA BLVD
Practice Address - Street 2:STE 101
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-3964
Practice Address - Country:US
Practice Address - Phone:818-461-0640
Practice Address - Fax:818-461-0641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-23
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEXE70110FMedicaid
CATP103Medicare PIN
CAP00020791Medicare PIN