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Organization
WESTERN IMAGING CENTER
Active
Organization
WESTERN IMAGING CENTER
Active
Parent organization
WESTERN DIAGNOSTIC & THERAPEUTIC RADIOLOGY MEDICAL GROUP
Other names
Western Imaging, Culver City
Organization subpart
Yes
Provider details
NPI number
Legal business name
WESTERN DIAGNOSTIC & THERAPEUTIC RADIOLOGY MEDICAL GROUP
Authorized official
DR. JOHN N LOIZEAUX-WITTE M.D. (MEDICAL DIRECTOR)
(310) 836-4700
Entity
Organization
Contact information
Practice address
9808 VENICE BLVD., 2ND FLOOR, CULVER CITY, CA 90232
(310) 836-4700
(310) 836-6925
Mailing address
9808 VENICE BLVD., 2ND FLOOR, CULVER CITY, CA 90232
(310) 836-4700
(310) 836-6925
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN3905
RAILROAD MEDICARE PIN
CA
05
—
GR0017072
—
CA
Enumeration date
10/02/2006
Last updated
03/13/2008
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