NPIMap

Organization Active NPI

Liberty Pacific Medical Imaging Encino, LLC

Doing business as Liberty Pacific MRI of Encino

  • Diagnostic Radiology Physician
  • Encino, CA
National Provider Identifier
1184672875
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
LIBERTY PACIFIC MEDICAL IMAGING ENCINO, LLC
Doing business as
Liberty Pacific MRI of Encino
Practice address
16130 Ventura Blvd
#100
Encino, CA 91436-2503
Phone
(818) 933-2020
Fax
(818) 933-2021
NPI assigned
May 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

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

Authorized official

Name
Renee (None) Kavon
Title
V.P. Marketing & Contracting
Phone
(530) 367-5295

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

16130 Ventura Blvd
#100
Encino, CA 91436-2503

Mailing address

PO Box 1279
Foresthill, CA 95631-1279
Phone (530) 367-5295

Other names 1

  • Liberty Pacific MRI of Encino Doing business as

National Provider Directory

National Provider Directory

Locations

File 50055
Los Angeles, CA 90074

2708 E Willow St
Signal Hill, CA 90755
Phone (562) 216-5120

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1184672875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1279",
            "city": "FORESTHILL",
            "state": "CA",
            "postal_code": "956311279",
            "telephone_number": "530-367-5295",
            "fax_number": "530-367-4634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16130 VENTURA BLVD",
            "address_2": "#100",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362503",
            "telephone_number": "818-933-2020",
            "fax_number": "818-933-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY PACIFIC MEDICAL IMAGING ENCINO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "KAVON",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "(NONE)",
        "authorized_official_title_or_position": "V.P. MARKETING & CONTRACTING",
        "authorized_official_telephone_number": "530-367-5295"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liberty Pacific MRI of Encino",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; 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.