Provider Demographics
NPI:1750537494
Name:ENCINO HOSPITAL RADIOLOGY MEDICAL GROUP INC
Entity type:Organization
Organization Name:ENCINO HOSPITAL RADIOLOGY MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:EINZIGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-881-9811
Mailing Address - Street 1:16237 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2201
Mailing Address - Country:US
Mailing Address - Phone:866-752-7080
Mailing Address - Fax:866-752-2240
Practice Address - Street 1:16237 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2201
Practice Address - Country:US
Practice Address - Phone:866-752-7080
Practice Address - Fax:866-752-2240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-13
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty