Encino Diagnostic Imaging Inc

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

ENCINO DIAGNOSTIC IMAGING INC

Practice address

16661 Ventura Blvd Ste 100
Encino, CA 91436-1922

Phone

(415) 595-8687

NPI assigned

Mar 14, 2024

Organization subpart

No

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

Authorized official

Name

Puneet ChandakNPI 1043276900

Title

Ceo/Owner

Phone

(415) 595-8687

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Puneet Chandak, M.D.

  • Nuclear Medicine Physician
  • Fremont, CA
  • NPI 1043276900
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1710374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1801655709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39120 ARGONAUT WAY STE 827",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16661 VENTURA BLVD STE 100",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914361922",
            "telephone_number": "415-595-8687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENCINO DIAGNOSTIC IMAGING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "CHANDAK",
        "authorized_official_first_name": "PUNEET",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "415-595-8687"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Encino Center Pharmacy Inc
• Encino Center Pharmacy Inc
• Encino Dental Excellence
• Encino Dental Group Inc a Professional Dental Corp
• Encino Derma Surgery Center, Inc.
• Encino Family Health Associates, Inc
• Encino Family Pharmacy Inc
• Encino Family Pharmacy Inc
• Encino Foot Care a Prof Corp
• Encino Health Corp

• Diagnostic Radiology Physician in Encino, CA
• Providers in Encino, 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 Oct 24, 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.