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Organization

VENTURA IMAGING AND RADIOLOGY CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HEDAYAT ED GOLCHEH M.D. (MEDICAL DIRECTOR)
(818) 905-7323
Entity
Organization

Contact information

Practice address
16311 VENTURA BLVD, SUITE # 787, ENCINO, CA 91436-2124
(818) 905-7323
(818) 783-6108
Mailing address
16311 VENTURA BLVD, SUITE # 787, ENCINO, CA 91436-2124
(818) 905-7323
(818) 783-6108

Taxonomy

Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
A040588
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A040588
MEDICAL LICENSE
CA
Enumeration date
02/13/2007
Last updated
05/16/2012
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