Antelope Valley Outpatient Imaging Center, LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

ANTELOPE VALLEY OUTPATIENT IMAGING CENTER, LLC

Practice address

44105 15TH St W Ste 100
Lancaster, CA 93534-4090

Phone

(661) 726-6050

Fax

(661) 951-4464

NPI assigned

Oct 20, 2020

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

Tax ID family

Antelope Valley Outpatient Imaging Cente2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Antelope Valley Outpatient Imaging Center, LLC

  • Diagnostic Radiology Physician
  • Lancaster, CA
  • NPI 1376143339
  NPD tax ID

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603152000000",
    "number": "1083213151",
    "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": "44105 15TH ST W STE 100",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935344090",
            "telephone_number": "661-726-6050",
            "fax_number": "661-951-4464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "43839 15th St W",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "CA",
            "postal_code": "935344756",
            "country_code": "US",
            "telephone_number": "661-726-6050",
            "fax_number": "661-951-4364",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "38925 Trade Center Dr Unit E",
            "address_purpose": "LOCATION",
            "city": "Palmdale",
            "state": "CA",
            "postal_code": "935513655",
            "country_code": "US",
            "telephone_number": "661-726-6050",
            "fax_number": "661-951-4364",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "38209 47th St E Ste D",
            "address_purpose": "LOCATION",
            "city": "Palmdale",
            "state": "CA",
            "postal_code": "935523113",
            "country_code": "US",
            "telephone_number": "661-726-6050",
            "fax_number": "661-951-4364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ANTELOPE VALLEY OUTPATIENT IMAGING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antelope Valley Nephrology Medical Group, Inc.
• Antelope Valley Neuroscience
• Antelope Valley Optometric Center, Inc.
• Antelope Valley Oral Surgery, Dental Group of Gregory R. Urfrig, DMD a
• Antelope Valley Orthopaedic& Rehabiliation Specialists
• Antelope Valley Outpatient Imaging Center, LLC
• Antelope Valley Outpatient Imaging Center, LLC
• Antelope Valley Outpatient Pharmacy LLC
• Antelope Valley Partners for Health
• Antelope Valley Physical Therapy, Inc.

• All providers in Lancaster, CA
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.