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Contact Information

BROADWAY IMAGING MEDICAL CENTER
140 NORTH GLENDALE AVE
GLENDALE, CA91206
 Phone: 818-548-0022
 Fax: 818-548-8385
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
 

Magnetic Resonance Imaging (MRI)

207RM1200X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for BROADWAY IMAGING MEDICAL CENTER

NPI Number 1497708002
LBN Legal business name BROADWAY IMAGING MEDICAL CENTER
Authorized official HOSAM MOUSTAFA - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 05/18/2006
Last updated 08/12/2018 - About 8 years ago
Identifiers
CA License # A71010
CA Medicaid 00A710100
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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