BROADWAY IMAGING MEDICAL CENTER (NPI# 1497708002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497708002 |
| Entity Type | Organization |
| Organization Name | BROADWAY IMAGING MEDICAL CENTER |
| Other Organization Name | BROADWAY IMAGING MEDICAL CENTER |
| Practice Address |
140 North Glendale Ave Glendale CA 91206 |
| Practice Telephone | 8185480022 |
| Practice Fax Number | 8185488385 |
| Mailing Telephone | 8185480022 |
| Mailing Fax Number | 8185488385 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2018-08-12 |
| Authorized Official Name | HOSAM M MOUSTAFA (PRESIDENT) |
| Authorized Official Telephone | 8185480022 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RM1200X |
Internal Medicine Specialization: Magnetic Resonance Imaging (MRI) |
A71010 | CA | Allopathic & Osteopathic Physicians |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
A71010 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A710100 | 05 |
| Other Name | Type Code |
|---|---|
| Broadway Imaging Medical Center | Former Legal Business Name - Organization |
| Street Address |
140 NORTH GLENDALE AVE |
| City | GLENDALE |
| State | CA |
| Zip Code | 91206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922611003 | Skyla L Bergin | Behavior Technician | 741 Glenvia St., Suite 200, Glendale, CA 91206 | 2020-08-28 |
| 1861017303 | Scm Nutrition Diet Inc | Dietitian, Registered | 2437 Bywood Drive, Glendale, CA 91206 | 2020-06-10 |
| 1336761295 | Glendale Whole Health | Family Medicine | 230 N Maryland Aave #110, Glendale, CA 91206 | 2020-05-14 |
| 1467010801 | Rebecca Bautista | Counselor | 223 North Jackson Street, Glendale, CA 91206 | 2019-05-31 |
| 1689132920 | M4l Transport Inc | Non-emergency Medical Transport (VAN) | 336 N Louise St #4d, Glendale, CA 91206 | 2019-03-05 |
| 1376042705 | Eileen Wong, Md Inc. | Physical Medicine & Rehabilitation | 2664 E Glenoaks Blvd, Glendale, CA 91206 | 2018-02-12 |
| 1629507900 | Aleksan Chakhoyan | Registered Nurse | 501 N. Glendale Ave., Glendale, CA 91206 | 2017-06-08 |
| 1851793343 | Sevak Olmessekian | Pharmacist | 230 N. Maryland Ave., Suite 307, Glendale, CA 91206 | 2014-09-16 |
| 1558762575 | Zyanya Mendoza | Clinical Neuropsychologist | 1560 E Chevy Chase Dr Ste 140, Glendale, CA 91206 | 2014-09-09 |
| 1629488358 | Nina Behdin | Surgery | 1560 E Chevy Chase Dr Ste 430, Glendale, CA 91206 | 2014-05-02 |
| Find all providers in zip 91206 | ||||
| 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 |
|---|---|---|---|---|
| 1952902116 | Vesta Telemedicine Solutions, Pllc | Radiology | 833 Americana Way Unit 251, Glendale, CA 91210-1538 | 2020-11-04 |
| 1780154153 | Bay Imaging Consultants Medical Group | Radiology | 435 W Los Feliz Rd Unit 462, Glendale, CA 91204-3569 | 2018-11-28 |
| 1851893317 | Main Street Radiology At Bayside LLC | Radiology | 8314 Cooper Ave, Glendale, NY 11385-7722 | 2018-03-01 |
| 1609284660 | Armen Aivazi | Radiology | 3335 Deer Creek Ln, Glendale, CA 91208-1166 | 2014-07-23 |
| 1043543275 | Smi Imaging, LLC | Radiology | 5410 W Thunderbird Rd Ste 221, Glendale, AZ 85306-4711 | 2009-09-04 |
| 1558594747 | Smi Imaging, LLC | Radiology | 5410 W Thunderbird Rd Ste 100, Glendale, AZ 85306-4711 | 2009-09-03 |
| 1336387059 | Saadet Atay-rosenthal | Radiology | 5601 W Saguaro Park Ln, Glendale, AZ 85310-2815 | 2009-02-03 |
| 1912166968 | Jeanne C Lammering | Radiology | 1144 Cordova Ave, Glendale, CA 91207-1751 | 2008-06-05 |
| 1740403104 | Glendale Diagnostic Imaging Network Medical Office, Inc | Radiology | 403 S Glendale Ave, Glendale, CA 91205-2222 | 2007-04-11 |
| 1689750382 | James Chouming Wu | Radiology | 1420 South Central Avenue, Glendale, CA 91204 | 2006-10-27 |
| Find all providers in GLENDALE | ||||
Please comment or provide details below to improve the information on BROADWAY IMAGING MEDICAL CENTER.
| 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.