Provider Demographics
NPI:1356403554
Name:IMPULSE IMAGING INC.
Entity type:Organization
Organization Name:IMPULSE IMAGING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:KHALETSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-784-7266
Mailing Address - Street 1:16200 VENTURA BLVD STE 412
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4900
Mailing Address - Country:US
Mailing Address - Phone:818-784-7266
Mailing Address - Fax:818-784-7266
Practice Address - Street 1:16200 VENTURA BLVD STE 412
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-4900
Practice Address - Country:US
Practice Address - Phone:818-784-7266
Practice Address - Fax:818-784-7266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Single Specialty