Organization
PROHEALTH ADVANCED IMAGING MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAYAM KASHFIAN M.D. (PRESIDENT)
(818) 301-6700
Entity
Organization
Contact information
Practice address
10767 RIVERSIDE DR, NORTH HOLLYWOOD, CA 91602-2324
(818) 301-6700
(818) 301-6701
Mailing address
10767 RIVERSIDE DR, NORTH HOLLYWOOD, CA 91602-2324
(818) 301-6700
(818) 301-6701
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ66550Z
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
05/02/2006
Last updated
03/27/2012
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