Provider Demographics
NPI:1295077956
Name:BEVERLY HILLS RADIOLOGY, LLC
Entity type:Organization
Organization Name:BEVERLY HILLS RADIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:SABRKHANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-294-7266
Mailing Address - Street 1:14622 VENTURA BLVD
Mailing Address - Street 2:725
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-3600
Mailing Address - Country:US
Mailing Address - Phone:323-300-6912
Mailing Address - Fax:
Practice Address - Street 1:5670 WILSHIRE BLVD FL 18
Practice Address - Street 2:1800
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-5679
Practice Address - Country:US
Practice Address - Phone:323-300-6912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-20
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
CA0002652713-0001-2261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty