Provider Demographics
NPI:1972042083
Name:A1 MEDICAL IMAGING INC
Entity Type:Organization
Organization Name:A1 MEDICAL IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAGUHI
Authorized Official - Middle Name:TINA
Authorized Official - Last Name:KESHISHIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-590-8557
Mailing Address - Street 1:731 GROTON DR
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-2422
Mailing Address - Country:US
Mailing Address - Phone:818-590-8557
Mailing Address - Fax:
Practice Address - Street 1:1577 E CHEVY CHASE DR STE 300
Practice Address - Street 2:SUITE #300
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4092
Practice Address - Country:US
Practice Address - Phone:818-240-8302
Practice Address - Fax:818-484-2996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-22
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1112352085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty