Provider Demographics
NPI:1831214030
Name:WESTWOOD OPEN MRI, LLC
Entity type:Organization
Organization Name:WESTWOOD OPEN MRI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JERROLD
Authorized Official - Middle Name:
Authorized Official - Last Name:MINK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-208-3100
Mailing Address - Street 1:10921 WILSHIRE BLVD
Mailing Address - Street 2:MEZZANINE LEVEL
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-3906
Mailing Address - Country:US
Mailing Address - Phone:310-208-3100
Mailing Address - Fax:310-208-3101
Practice Address - Street 1:2112 E 4TH ST
Practice Address - Street 2:SUITE 220
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3816
Practice Address - Country:US
Practice Address - Phone:714-835-9080
Practice Address - Fax:714-835-0114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG733732085N0700X
CAG226912085R0202X
CAG847122085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiologyGroup - Single Specialty
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty