Organization Name: | WILBUR IMAGING PARTNERS INC |
NPI Number: | 1003040189 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JACOB RASTEGAR (PRESIDENT) |
Mailing Address: | 5620 Wilbur Ave 209-210 Tarzana |
State: | CA US |
Postal Code: | 913561351 |
Phone Number: | 8187053200 |
Fax Number: | 8187056999 |
NPI Enumeration Date: | 05/05/2009 |
NPI Last Update Date: | 07/23/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Radiology |
Taxonomy Definition: |