Basic Information
Provider Information
NPI: 1548802994
EntityType: 2
ReplacementNPI:  
OrganizationName: UNITED MEDICAL RADIOLOGY NETWORK, INC.
LastName:  
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Mailing Information
Address1: PO BOX 491149
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900499149
CountryCode: US
TelephoneNumber: 3109438400
FaxNumber: 3109239912
Practice Location
Address1: 3501 S HARBOR BLVD STE M
Address2:  
City: SANTA ANA
State: CA
PostalCode: 927046919
CountryCode: US
TelephoneNumber: 7146197888
FaxNumber: 7146197887
Other Information
ProviderEnumerationDate: 10/16/2019
LastUpdateDate: 10/16/2019
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: ZARIAN
AuthorizedOfficialFirstName: DAVID
AuthorizedOfficialMiddleName: H
AuthorizedOfficialTitleorPosition: OWNER/PRESIDENT
AuthorizedOfficialTelephone: 3109438400
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X  Y193400000X MULTIPLE SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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