Provider Demographics
NPI:1184388209
Name:JT IMAGING MOBILE X-RAY
Entity type:Organization
Organization Name:JT IMAGING MOBILE X-RAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MAGED
Authorized Official - Middle Name:
Authorized Official - Last Name:TAWADROS
Authorized Official - Suffix:
Authorized Official - Credentials:RT
Authorized Official - Phone:626-483-2632
Mailing Address - Street 1:11017 W HONDO PKWY UNIT B
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-5606
Mailing Address - Country:US
Mailing Address - Phone:626-483-2632
Mailing Address - Fax:626-941-6566
Practice Address - Street 1:11017 W HONDO PKWY UNIT B
Practice Address - Street 2:
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780-5606
Practice Address - Country:US
Practice Address - Phone:626-483-2632
Practice Address - Fax:626-941-6566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier