Provider Demographics
NPI:1245916758
Name:PREFERRED IMAGING CENTER INC
Entity type:Organization
Organization Name:PREFERRED IMAGING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAKULIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-649-1374
Mailing Address - Street 1:1995 POLARIS DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-2424
Mailing Address - Country:US
Mailing Address - Phone:818-649-1374
Mailing Address - Fax:818-649-1375
Practice Address - Street 1:1995 POLARIS DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208-2424
Practice Address - Country:US
Practice Address - Phone:818-649-1374
Practice Address - Fax:818-649-1375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-27
Last Update Date:2023-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier