Antelope Valley Outpatient Imaging Center, LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

ANTELOPE VALLEY OUTPATIENT IMAGING CENTER, LLC

Practice address

43839 15TH St W
Lancaster, CA 93534-4756

Phone

(661) 726-6050

Fax

(661) 951-4464

NPI assigned

Oct 29, 2020

Last updated

Oct 29, 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
  • Palmdale, CA
  • NPI 1003415613

  9537072996

  Same PAC ID
• Antelope Valley Outpatient Imaging Center, LLC

  • Diagnostic Radiology Physician
  • Palmdale, CA
  • NPI 1558960161

  9537072996

  Same PAC ID

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 1083213151
  NPD tax ID

Member of 1

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

• Antelope Valley Hospital District

  • Home Health Agency
  • Lancaster, CA
  • NPI 1487657235

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603929600000",
    "number": "1376143339",
    "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": "43839 15TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935344756",
            "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": "2020-10-29",
        "last_updated": "2020-10-29",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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. (Rancho Wellness Center)
• Antelope Valley Primary Care Group

• Diagnostic Radiology Physician in Lancaster, CA
• Providers in Lancaster, 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 29, 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.