Broadway Mammography, LLC

Primary specialty

Mammography Clinic/CenterTaxonomy code 261QR0206X

Legal business name

BROADWAY MAMMOGRAPHY, LLC

Practice address

231 W Vernon Ave Ste 106
Los Angeles, CA 90037-2778

Phone

(323) 991-4009

Fax

(323) 991-4006

NPI assigned

Aug 5, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Gene Eason

Title

Administrator

Phone

(323) 991-4009

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1659657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659657600000",
    "number": "1457088783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 W VERNON AVE STE 106",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900372778",
            "telephone_number": "323-991-4009",
            "fax_number": "323-991-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 W VERNON AVE STE 106",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900372778",
            "telephone_number": "323-991-4009",
            "fax_number": "323-991-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY MAMMOGRAPHY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-05",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A",
        "authorized_official_last_name": "EASON",
        "authorized_official_first_name": "GENE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "323-991-4009",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adela Brock
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• Mammography Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Mammography Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; 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.