Basic Information
| Provider Information | |||||||||
| NPI: | 1184159899 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNITED MEDICAL RADIOLOGY NETWORK, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | UNITED MEDICAL RADIOLOGY NETWORK OF WEST COVINA | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1401 W. MERCED AVE #102 | ||||||||
| Address2: | |||||||||
| City: | WEST COVINA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91790 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6268136100 | ||||||||
| FaxNumber: | 6268130075 | ||||||||
| Practice Location | |||||||||
| Address1: | 1401 W MERCED AVE | ||||||||
| Address2: | #102 | ||||||||
| City: | WEST COVINA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917903401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6268136100 | ||||||||
| FaxNumber: | 6268130075 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2017 | ||||||||
| LastUpdateDate: | 05/01/2017 | ||||||||
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| AuthorizedOfficialLastName: | ZARIAN | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | H | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3109438400 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Radiology |
No ID Information.