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Organization
MULTI DIAGNOSTIC IMAGING AND BREAST CENTER MEDICAL GROUP INC.
Active
Organization
MULTI DIAGNOSTIC IMAGING AND BREAST CENTER MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHOSROW SADRIEH M.D. (PRESIDENT)
(818) 986-8215
Entity
Organization
Contact information
Practice address
4910 VAN NUYS BLVD, 110, SHERMAN OAKS, CA 91403-1782
(818) 986-8215
(818) 986-9582
Mailing address
4910 VAN NUYS BLVD, 110, SHERMAN OAKS, CA 91403-1782
(818) 986-8215
(818) 986-9582
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A29572
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A295720
—
CA
01
—
ZZZ48958Z
BLUE SHIELD PROVIDER NUMB
CA
01
—
ZZZ97621Z
BLUE CROSS PROVIDER NUMBE
CA
Enumeration date
10/17/2006
Last updated
08/22/2020
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