ANTELOPE VALLEY OUTPATIENT IMAGING CENTER, LLC (NPI# 1083213151) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083213151 |
| Entity Type | Organization |
| Organization Name | ANTELOPE VALLEY OUTPATIENT IMAGING CENTER, LLC |
| Practice Address |
44105 15th St W Ste 100 Lancaster CA 93534-4090 |
| Mailing Address |
Po Box 190 Simi Valley CA 93062-0190 |
| Practice Telephone | 6617266050 |
| Practice Fax Number | 6619514464 |
| Mailing Telephone | 8555044544 |
| Mailing Fax Number | 8055772018 |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2020-10-20 |
| Authorized Official Name | MR. EDWARD MIRZABEGIAN (MANAGER) |
| Authorized Official Telephone | 6619495533 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 38209 47th St E Ste D, Palmdale, CA 935523113 | 6617266050 | 6619514364 |
| 38925 Trade Center Dr Unit E, Palmdale, CA 935513655 | 6617266050 | 6619514364 |
| 43839 15th St W, Lancaster, CA 935344756 | 6617266050 | 6619514364 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558960161 | Antelope Valley Outpatient Imaging Center, LLC | Radiology | 38209 47th St E Ste D, Palmdale, CA 93552-3113 | 2020-10-23 |
| 1003415613 | Antelope Valley Outpatient Imaging Center, LLC | Radiology | 38925 Trade Center Dr Unit E, Palmdale, CA 93551-3655 | 2020-10-23 |
| 1376143339 | Antelope Valley Outpatient Imaging Center, LLC | Radiology | 43839 15th St W, Lancaster, CA 93534-4756 | 2020-10-29 |
| 1871193763 | Antelope Valley Outpatient Imaging Center, LLC | Radiology | 44105 15th St W Ste 100, Lancaster, CA 93534-4090 | 2020-10-29 |
| Street Address |
44105 15TH ST W STE 100 |
| City | LANCASTER |
| State | CA |
| Zip Code | 93534-4090 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871193763 | Antelope Valley Outpatient Imaging Center, LLC | Radiology | 44105 15th St W Ste 100, Lancaster, CA 93534-4090 | 2020-10-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194346098 | Lori Ann Barlow Washington | Counselor | 921 W J Street, Lancaster, CA 93534 | 2020-05-01 |
| 1629698253 | Gisela Regalado Paredes | Surgery | Antelope Valley Hospital, 1600 West Ave J, Lancaster, CA 93534 | 2020-04-23 |
| 1124668470 | Latonya Jean Allen | Case Manager/Care Coordinator | 44443 10th St. West, Lancaster, CA 93534 | 2020-01-14 |
| 1629629746 | Korinna Fite | Occupational Therapy Assistant | 43860 10th St. W., Lancaster, CA 93534 | 2019-09-20 |
| 1114576105 | Victor Nemr Hass Md | Anesthesiology | Embassy Surgery Center, 42135 10th Street West 325, Lancaster, CA 93534 | 2019-09-11 |
| 1609421007 | Jaime A Mort | Nurse Practitioner | 43112 N 15st W, Lancaster, CA 93534 | 2019-08-03 |
| 1013560747 | Allyson Lods | Dietitian, Registered | 43115 15th Street West, Lancaster, CA 93534 | 2019-07-22 |
| 1144884123 | Nicole Breanne Palman | Speech-Language Pathologist | 43860 10th St. West, 1st Floor, Lancaster, CA 93534 | 2019-04-25 |
| 1841761475 | Vanessa Gonzalez | Case Manager/Care Coordinator | 44226 10th St West, Lancaster, CA 93534 | 2018-12-07 |
| 1760969265 | Marilyn Joy Pollack | Physical Therapy Assistant | 1306 W Avenue J Ste 2, Lancaster, CA 93534 | 2018-07-26 |
| Find all providers in zip 93534 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437548484 | Los Robles Radiologic Associates | Radiology | 44928 Shad St, Lancaster, CA 93536-8533 | 2015-01-14 |
| 1356762074 | Edwin Robert Payne | Radiology | 465 Overlook Dr Ne, Lancaster, OH 43130-1918 | 2013-12-23 |
| 1689977308 | John William Gareis | Radiology | 2101 Millersville Pike, Lancaster, PA 17603-6216 | 2010-12-20 |
| 1124104237 | Harmadeep K Gill Medical Corporation | Radiology | 43807 10th Street West, Suite C, Lancaster, CA 93534-4805 | 2006-10-31 |
| 1306884648 | Beverly Radiology Medical Group | Radiology | 43713 20th St W, Lancaster, CA 93534-4628 | 2006-06-02 |
| 1710931381 | Beverly Radiology Medical Group | Radiology | 44305 Lorimer Ave, Lancaster, CA 93534-3700 | 2006-05-19 |
| 1851355473 | Ray H Hashemi | Radiology | 43731 N 15 St West, Lancaster, CA 93534 | 2006-04-12 |
| 1679542179 | Harry Zibners | Radiology | 1241 River Valley Blvd, Lancaster, OH 43130-1653 | 2006-03-16 |
| 1164408993 | Mohammad Reza Kazemaini Mofrad | Radiology | 43112 15th St W, Lancaster, CA 93534-6219 | 2005-12-22 |
| 1316940349 | Cindy Janesky | Radiology | 555 N Duke St, Lancaster, PA 17602-2250 | 2005-05-23 |
| Find all providers in LANCASTER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.