Organization Active NPI

Glenoaks Imaging Professionals Inc

  • Radiology Clinic/Center
  • Glendale, CA
National Provider Identifier
1205137189
Registry record updated Jul 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
GLENOAKS IMAGING PROFESSIONALS INC
Practice address
1731 W Glenoaks Blvd
Suite 101 & Suite 102
Glendale, CA 91201-1599
Phone
(818) 429-3324
NPI assigned
Nov 9, 2010
Last updated
Jul 26, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2011

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

Authorized official

Name
Rubik Khosrovyan
Title
President
Phone
(818) 429-3324

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X CA Primary

Addresses

Primary practice location

1731 W Glenoaks Blvd
Suite 101 & Suite 102
Glendale, CA 91201-1599

Mailing address

1731 W Glenoaks Blvd
Suite 101 & Suite 102
Glendale, CA 91201-1599

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111027000596 CA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 3971776436 Practice locations: Glendale, CA

National Provider Directory

National Provider Directory

Locations

1731 W Glenoaks Blvd
Ste 101
Glendale, CA 91201
Phone (818) 230-3400

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311638400000",
    "number": "1205137189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1731 W GLENOAKS BLVD",
            "address_2": "SUITE 101 & SUITE 102",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912011599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1731 W GLENOAKS BLVD",
            "address_2": "SUITE 101 & SUITE 102",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912011599",
            "telephone_number": "818-429-3324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENOAKS IMAGING PROFESSIONALS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-09",
        "last_updated": "2011-07-26",
        "status": "A",
        "authorized_official_last_name": "KHOSROVYAN",
        "authorized_official_first_name": "RUBIK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-429-3324"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; 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.