Provider Demographics
NPI:1457547663
Name:M.R.DIAGNOSTIC IMAGING, INC
Entity type:Organization
Organization Name:M.R.DIAGNOSTIC IMAGING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LILIYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEPPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-659-1303
Mailing Address - Street 1:116 N SWALL DR APT 202
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1926
Mailing Address - Country:US
Mailing Address - Phone:310-659-1303
Mailing Address - Fax:818-888-1544
Practice Address - Street 1:116 N SWALL DR APT 202
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1926
Practice Address - Country:US
Practice Address - Phone:310-659-1303
Practice Address - Fax:818-888-1544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty