Organization Active NPI

U.S. Diagnostic Management Inc

  • Mobile Radiology Clinic/Center
  • Burbank, CA
National Provider Identifier
1699279588
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X
Legal business name
U.S. DIAGNOSTIC MANAGEMENT INC
Practice address
2829 W Burbank Blvd Ste 202
Burbank, CA 91505-2300
Phone
(747) 477-1064
NPI assigned
Mar 23, 2018
Last updated
Aug 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Authorized official

Name
Henry Okonkwo
Title
Ceo
Phone
(424) 866-9046

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Ultrasound Physician 2085U0001X NU
Mobile Radiology Clinic/Center 261QR0208X NU Primary

Addresses

Primary practice location

2829 W Burbank Blvd Ste 202
Burbank, CA 91505-2300

Mailing address

2829 W Burbank Blvd Ste 202
Burbank, CA 91505-2300
Phone (747) 477-1064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20181201000053 CA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 4082958053 Practice locations: Redondo Beach, CA
O20240913000904 CA Part B Supplier - Portable X-Ray Supplier 4082958053 Practice locations: Redondo Beach, CA

National Provider Directory

National Provider Directory

Locations

1416 Aviation Blvd
Redondo Beach, CA 90278
Phone (424) 866-9046

1416 Aviation Blvd
Ste B
Redondo Beach, CA 90278
Phone (747) 477-1064

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723680000000",
    "number": "1699279588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 W BURBANK BLVD STE 202",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915052300",
            "telephone_number": "747-477-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2829 W BURBANK BLVD STE 202",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915052300",
            "telephone_number": "747-477-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "U.S. DIAGNOSTIC MANAGEMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-23",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A",
        "authorized_official_last_name": "OKONKWO",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "424-866-9046"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.

Verify at the official NPI Registry.