Provider Demographics
NPI:1972938876
Name:SONIC RADIOLOGY SERVICES
Entity Type:Organization
Organization Name:SONIC RADIOLOGY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HAMID
Authorized Official - Middle Name:
Authorized Official - Last Name:KOUROSHY
Authorized Official - Suffix:
Authorized Official - Credentials:RT
Authorized Official - Phone:818-300-7885
Mailing Address - Street 1:23148 PARK CONTESSA
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1709
Mailing Address - Country:US
Mailing Address - Phone:818-300-7885
Mailing Address - Fax:818-222-2360
Practice Address - Street 1:23148 PARK CONTESSA
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1709
Practice Address - Country:US
Practice Address - Phone:818-300-7885
Practice Address - Fax:818-222-2360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARHF000663552471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiographyGroup - Single Specialty