Provider Demographics
NPI:1457788630
Name:A & G DIAGNOSTICS IMAGING INC
Entity Type:Organization
Organization Name:A & G DIAGNOSTICS IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALBINA
Authorized Official - Middle Name:
Authorized Official - Last Name:TIKHONOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-422-6225
Mailing Address - Street 1:4343 CRENSHAW BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-4929
Mailing Address - Country:US
Mailing Address - Phone:213-422-6225
Mailing Address - Fax:
Practice Address - Street 1:4501 CEDROS AVE UNIT 340
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-2840
Practice Address - Country:US
Practice Address - Phone:213-422-6225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty