Iraj Khalkhali, M.D., Inc.

Primary specialty

Mobile Mammography Clinic/CenterTaxonomy code 261QR0207X

License

44916 Issued in CA

Legal business name

IRAJ KHALKHALI, M.D., INC.

Doing business as

Willow Center Imaging

Practice address

500 W Willow St Ste 8
Long Beach, CA 90806-2831

Phone

(562) 424-9906

Fax

(562) 427-9831

NPI assigned

May 25, 2007

Last updated

Aug 22, 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

Dr. Iraj Khalkhali, M.D.

Title

Medical Director Radiologist

Phone

(562) 424-9906

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Willow Center Imaging Doing business as

Locations

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275744559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W WILLOW ST STE 8",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062831",
            "telephone_number": "562-424-9906",
            "fax_number": "562-427-9831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W WILLOW ST STE 8",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062831",
            "telephone_number": "562-424-9906",
            "fax_number": "562-427-9831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRAJ KHALKHALI, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KHALKHALI",
        "authorized_official_first_name": "IRAJ",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR RADIOLOGIST",
        "authorized_official_telephone_number": "562-424-9906",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0207X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile Mammography",
            "state": "CA",
            "license": "44916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A320230",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willow Center Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinic/Center in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.