Provider Demographics
NPI:1467638064
Name:ADVANCED IMAGING CENTER, INC.
Entity type:Organization
Organization Name:ADVANCED IMAGING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:H
Authorized Official - Last Name:HASHEMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-949-8111
Mailing Address - Street 1:PO BOX 16007
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91416-6007
Mailing Address - Country:US
Mailing Address - Phone:661-949-8111
Mailing Address - Fax:661-940-0994
Practice Address - Street 1:43731 15TH ST W
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4785
Practice Address - Country:US
Practice Address - Phone:661-949-8111
Practice Address - Fax:661-940-0994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty