San Fernando Diagnostic and Imaging, Inc

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

SAN FERNANDO DIAGNOSTIC AND IMAGING, INC

Practice address

211 S Maclay Ave
San Fernando, CA 91340-3603

Phone

(818) 408-2500

NPI assigned

Jul 24, 2009

Last updated

Jul 24, 2009By 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

Robert L Wilson, M.D.

Title

Ceo

Phone

(818) 361-5269

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248393600000",
    "number": "1538399555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16060 VENTURA BLVD STE 105-338",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362761",
            "telephone_number": "818-361-5269",
            "fax_number": "818-837-7291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S MACLAY AVE",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913403603",
            "telephone_number": "818-408-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN FERNANDO DIAGNOSTIC AND IMAGING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-24",
        "last_updated": "2009-07-24",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-361-5269",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christojohn Samuel, MD
• San Fernando Community Health Center
• San Fernando Community Hospital (San Fernando Community Health Center)
• San Fernando Dental Care
• San Fernando Dental Center (Dr Jerry B Malleus)
• San Fernando Pharmacy Incorporated
• San Fernando Recovery Center
• San Fernando Recovery Center
• San Fernando Valley Community Mental Health Center, Inc. (San Fernando Valley CMHC Family Links)
• San Fernando Youth Organization

• Diagnostic Radiology Physician in San Fernando, CA
• Providers in San Fernando, 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 Jul 24, 2009; 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.