Organization
SOUTH VALLEY IMAGING
Active
Other names
South Valley Imaging Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL KYLE BURTNETT (SVP OF OUTPATIENT SERVICES, TENET)
(469) 893-2153
Entity
Organization
Contact information
Practice address
18344 CLARK ST, SUITE 101, TARZANA, CA 91356-3505
(818) 881-9811
Mailing address
PO BOX 16699, IRVINE, CA 92623-6699
(818) 881-9811
(818) 881-1638
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
NA
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ90381Z
BLUE SHIELD
CA
Enumeration date
06/25/2006
Last updated
06/23/2016
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