Fubos Imaging, Inc.

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

FUBOS IMAGING, INC.

Practice address

11161 Crenshaw Blvd
Suite 120
Inglewood, CA 90303-2336

Phone

(310) 590-1547

Fax

(310) 590-1546

NPI assigned

May 26, 2006

Organization subpart

No

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

Authorized official

Name

Viktoriya Kondratyuk

Title

President

Phone

(310) 590-1547

Specialties & licenses 1

Addresses

Other names 1

• Imperial Diagnostic Doing business as

Locations

Practitioners 1

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

• Nahid Nazarian, M.D.

  • Diagnostic Radiology Physician
  • Beverly Hills, CA
  • NPI 1821036526
  NPD (past)

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": "1891741385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11161 CRENSHAW BLVD",
            "address_2": "SUITE 120",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903032336",
            "telephone_number": "310-590-1547",
            "fax_number": "310-590-1546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11161 CRENSHAW BLVD",
            "address_2": "SUITE 120",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903032336",
            "telephone_number": "310-590-1547",
            "fax_number": "310-590-1546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUBOS IMAGING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KONDRATYUK",
        "authorized_official_first_name": "VIKTORIYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-590-1547"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Imperial Diagnostic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Fresenius Medical Care - Eucalyptus, LLC
• Scott Frieden
• Modena Frye-Patch
• Gynaa Fryer, LVN
• Susan Fu
• Eunice Dolores Fuentes
• Magdalena Fuentes
• Yoana B Fuller Luna, DDS
• Functional Restoration Medical Center, Inc,
• Pamela D Funderburk

• Radiology Clinic/Center in Inglewood, CA
• Providers in Inglewood, CA by specialty
• Radiology Clinic/Center 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.