Provider Demographics
NPI:1922135359
Name:CEDARS-SINAI IMAGING MEDICAL GROUP A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:CEDARS-SINAI IMAGING MEDICAL GROUP A PROFESSIONAL CORPORATION
Other - Org Name:CSI
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT, CFO, CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:PRESSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:AUTHORIZED SIGNER
Authorized Official - Phone:310-423-6500
Mailing Address - Street 1:PO BOX 607
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91319-0607
Mailing Address - Country:US
Mailing Address - Phone:800-303-3044
Mailing Address - Fax:805-375-8903
Practice Address - Street 1:8700 BEVERLY BLVD # M-335
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-1804
Practice Address - Country:US
Practice Address - Phone:310-423-6500
Practice Address - Fax:310-423-5654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0053310Medicaid
CAZZZ33631ZOtherBLUE SHIELD OF CALIF
200167900OtherDEPT OF LABOR
CAZZZ33631ZOtherBLUE SHIELD OF CALIF