Organization
GRAND AVENUE IMAGING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GENE EASON (ADMINISTRATOR)
(213) 746-5800
Entity
Organization
Contact information
Practice address
1400 S GRAND AVE STE 608, LOS ANGELES, CA 90015-3068
(213) 746-5800
(213) 746-5802
Mailing address
1400 S GRAND AVE STE 608, LOS ANGELES, CA 90015-3068
(213) 746-5800
(213) 746-5802
Taxonomy
Speciality
Code
Description
License number
State
261QR0206X
Mammography Clinic/Center
Primary
FAC 48220
CA
Other
Enumeration date
07/12/2007
Last updated
06/21/2018
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