Antelope Valley Outpatient Imaging Center, LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

ANTELOPE VALLEY OUTPATIENT IMAGING CENTER, LLC

Practice address

38925 Trade Center Dr Unit E
Palmdale, CA 93551-3655

Phone

(661) 726-6050

Fax

(661) 951-4464

NPI assigned

Oct 23, 2020

Last updated

Oct 23, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Edward Mirzabegian

Title

Manager

Phone

(661) 949-5533

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Antelope Valley Outpatient Imaging Center, LLC

  • Diagnostic Radiology Physician
  • Lancaster, CA
  • NPI 1376143339

  9537072996

  Same PAC ID
• Antelope Valley Outpatient Imaging Center, LLC

  • Diagnostic Radiology Physician
  • Palmdale, CA
  • NPI 1558960161

  9537072996

  Same PAC ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Antelope Valley Health Care District

  dba Antelope Valley Medical Center Infusion

  • Home Infusion Therapy Pharmacy
  • Lancaster, CA
  • NPI 1194433938

  Member Of

  NPD member

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603411200000",
    "number": "1003415613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930620190",
            "telephone_number": "855-504-4544",
            "fax_number": "805-577-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38925 TRADE CENTER DR UNIT E",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935513655",
            "telephone_number": "661-726-6050",
            "fax_number": "661-951-4464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTELOPE VALLEY OUTPATIENT IMAGING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-23",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A",
        "authorized_official_last_name": "MIRZABEGIAN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "661-949-5533",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antelope Valley Family Optometry, Inc (Antelope Valley Family Optometry)
• Antelope Valley Home Health Agency Inc.
• Antelope Valley Hospital OB Clinic Palmdale
• Antelope Valley Impotence & Incontinence Medical Center, Inc
• Antelope Valley Lung & Sleep Institute, Inc
• Antelope Valley Outpatient Imaging Center, LLC
• Antelope Valley Specialty Surgical Center, LLC
• Antelope Valley Summit Medical Group, Inc (Summit Urgent Care)
• Antelope Valley Surgery Center, PC
• Antelope Valley Women's Healthcare, Inc

• Diagnostic Radiology Physician in Palmdale, CA
• Providers in Palmdale, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.