Provider Demographics
NPI:1720281504
Name:MEDISCAN PLUS, INC
Entity Type:Organization
Organization Name:MEDISCAN PLUS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VADIM
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIELIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-821-7772
Mailing Address - Street 1:9439 VIA VENEZIA
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-1244
Mailing Address - Country:US
Mailing Address - Phone:818-767-4729
Mailing Address - Fax:818-767-4729
Practice Address - Street 1:2616 SOUTH LOOP W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2662
Practice Address - Country:US
Practice Address - Phone:713-432-7410
Practice Address - Fax:713-432-7410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile