Basic Information
Provider Information
NPI: 1871869529
EntityType: 2
ReplacementNPI:  
OrganizationName: UNITED MEDICAL RADIOLOGY NETWORK
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: UMRN OF ANAHEIM
OtherOrganizationType: 5
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 491160
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900499160
CountryCode: US
TelephoneNumber: 3104742288
FaxNumber:  
Practice Location
Address1: 1801 W ROMNEYA DR
Address2: SUITE 104
City: ANAHEIM
State: CA
PostalCode: 928011830
CountryCode: US
TelephoneNumber: 7146784000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/27/2012
LastUpdateDate: 01/18/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ZARIAN
AuthorizedOfficialFirstName: DAVID
AuthorizedOfficialMiddleName: H
AuthorizedOfficialTitleorPosition: MEDICAL DIRECTOR
AuthorizedOfficialTelephone: 3109438400
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: M.D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QR0206X  Y Ambulatory Health Care FacilitiesClinic/CenterRadiology, Mammography

No ID Information.


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