Professional Imaging Medical Group
Organization Active NPI Diagnostic Radiology Physician · Mission Hills, CA
NPI 1447477161 · NPPES record last updated Jul 18, 2008
Key facts
- NPI
- 1447477161
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- PROFESSIONAL IMAGING MEDICAL GROUP
- Practice address
- 15031 Rinaldi St
Mission Hills, CA 91345-1207 - Phone
- (818) 365-8051
- Fax
- (818) 898-4451
- NPI assigned
- Apr 20, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Gregory Lewis Paranay, M.D.
- Title
- Partner
- Phone
- (818) 898-4530
Practitioners 18
-
Kambrie Yukie Kato, M.D.
-
David Lee, M.D.
-
Tadesse Eshetu, M.D.
-
Patrick T. Hurley, M.D.
-
Jigish S. Patel, M.D.
-
Derek R Armfield, MD
-
Robert Mark Agulnek, M.D.
-
Theodore Allen Hittle, M.D.
-
Daniel Kirsch, MD
-
Donald C Blake, M.D.
-
Lloyd David Wagner, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (4 enrollments) in MO, HI, WA, DC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221104002229 | MO | Part B Supplier - Clinic/Group Practice | 2062440126 |
Receives reassigned benefits from 1 practitioner Practice locations: Saint Louis, MO |
| O20221221003218 | HI | Part B Supplier - Clinic/Group Practice | 2062440126 |
Receives reassigned benefits from 1 practitioner Practice locations: Kaneohe, HI |
| O20221223001196 | WA | Part B Supplier - Clinic/Group Practice | 2062440126 |
Receives reassigned benefits from 8 practitioners Practice locations: Sammamish, WA; Seattle, WA; Everett, WA; Camas, WA; Bothell, WA; Bellevue, WA |
| O20230207002319 | DC | Part B Supplier - Clinic/Group Practice | 2062440126 |
Receives reassigned benefits from 1 practitioner Practice locations: Washington, DC |
National Provider Directory
Locations
15650 Devonshire St
Granada Hills, CA 91344
Phone (818) 351-7321
19950 Rinaldi St
Ste 101B
Porter Ranch, CA 91326
Phone (818) 496-7517
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Body Imaging Physician |
2085B0100X | |||
| Neuroradiology Physician |
2085N0700X | |||
| Nuclear Radiology Physician |
2085N0904X | |||
| Pediatric Radiology Physician |
2085P0229X | |||
| Diagnostic Radiology Physician |
2085R0202X | Yes | ||
| Vascular & Interventional Radiology Physician |
2085R0204X | |||
| Diagnostic Ultrasound Physician |
2085U0001X |
Addresses
Primary practice location
15031 Rinaldi St
Mission Hills, CA 91345-1207
Mailing address
25020 Avenue Stanford
Suite 50
Valencia, CA 91355-3430
Phone (661) 295-0260
Other providers in Mission Hills, CA
- Andrew M Pourmoussa
- Pregnancy Counseling Center
- Priority Home Health Care, Inc.
- Douglas Louis Prisco
- Pro-Service Home Health
- Professional Nurses Home Care Inc
- Prohealth Medical Group, Inc
- Prohealth-Valley Occupational Medical Group
- Providence Facey Medical Foundation
- Providence Health System - Southern California
All providers in Mission Hills, CA · Diagnostic Radiology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.