MDC Radiology, Inc.

Primary specialty

Sonography Radiologic TechnologistTaxonomy code 2471S1302X

License

2872835 Issued in CA

Legal business name

MDC RADIOLOGY, INC.

Practice address

373 W Palmer Ave
Unit C
Glendale, CA 91204-2290

Phone

(818) 545-7177

Fax

(818) 545-7126

NPI assigned

May 26, 2006

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

Deimante Mundryte

Title

Ceo

Phone

(818) 545-7177

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457307803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "373 W PALMER AVE",
            "address_2": "UNIT C",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042290",
            "telephone_number": "818-545-7177",
            "fax_number": "818-545-7126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "373 W PALMER AVE",
            "address_2": "UNIT C",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042290",
            "telephone_number": "818-545-7177",
            "fax_number": "818-545-7126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDC RADIOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MUNDRYTE",
        "authorized_official_first_name": "DEIMANTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-545-7177"
    },
    "taxonomies": [
        {
            "code": "2471S1302X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiologic Technologist, Sonography",
            "state": "CA",
            "license": "2872835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sonography Radiologic Technologist in Glendale, CA
• Providers in Glendale, CA by specialty
• Sonography Radiologic Technologist 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.