Active NPI
Lynwood Medical Imaging LLC
- Diagnostic Radiology Physician
- Walnut Park, CA
National Provider Identifier
1396791497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- LYNWOOD MEDICAL IMAGING LLC
- Practice address
- 2638 E Florence Ave
Walnut Park, CA 90255-4708 - Phone
- (323) 588-3800
- Fax
- (323) 277-0399
- NPI assigned
- May 26, 2006
- Last updated
- Nov 4, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Sepehr Katiraie, M.D.
- Title
- Owner/Ceo
- Phone
- (323) 588-3800
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiology Clinic/Center | 261QR0200X | NU | ||
| Diagnostic Radiology Physician | 2085R0202X | NU | Primary |
Addresses
Primary practice location
2638 E Florence Ave
Walnut Park, CA 90255-4708
Mailing address
2638 E Florence Ave
Walnut Park, CA 90255-4708
Phone (323) 588-3800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080408000935 | CA | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1557448073 | Practice locations: Lynwood, CA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 5
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.
-
- Family Medicine Physician
- Huntington Park, CA
- NPI 1225084213
-
- Diagnostic Radiology Physician
- Bakersfield, CA
- NPI 1720191737
-
- Diagnostic Radiology Physician
- Lynwood, CA
- NPI 1205876869
-
- Emergency Medicine Physician
- Santa Monica, CA
- NPI 1639136674
-
- Diagnostic Radiology Physician
- Downey, CA
- NPI 1881737021
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1730678400000",
"number": "1396791497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2638 E FLORENCE AVE",
"city": "WALNUT PARK",
"state": "CA",
"postal_code": "902554708",
"telephone_number": "323-588-3800",
"fax_number": "323-277-0399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2638 E FLORENCE AVE",
"city": "WALNUT PARK",
"state": "CA",
"postal_code": "902554708",
"telephone_number": "323-588-3800",
"fax_number": "323-277-0399"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LYNWOOD MEDICAL IMAGING LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-26",
"last_updated": "2024-11-04",
"certification_date": "2024-11-04",
"status": "A",
"authorized_official_last_name": "KATIRAIE",
"authorized_official_first_name": "SEPEHR",
"authorized_official_title_or_position": "OWNER/CEO",
"authorized_official_telephone_number": "323-588-3800",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "261QR0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Radiology",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Walnut Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.