Provider Demographics
NPI:1285192799
Name:RIVANDI IMAGING AND HEALTHCARE INC.
Entity type:Organization
Organization Name:RIVANDI IMAGING AND HEALTHCARE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:HOSSEINI RIVANDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-595-6753
Mailing Address - Street 1:10910 LONG BEACH BLVD STE 103-108
Mailing Address - Street 2:
Mailing Address - City:LYNWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90262-2689
Mailing Address - Country:US
Mailing Address - Phone:323-484-0086
Mailing Address - Fax:323-484-0411
Practice Address - Street 1:8401 LONG BEACH BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH GATE
Practice Address - State:CA
Practice Address - Zip Code:90280-2014
Practice Address - Country:US
Practice Address - Phone:323-484-0086
Practice Address - Fax:323-484-0411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-05
Last Update Date:2022-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No207U00000XAllopathic & Osteopathic PhysiciansNuclear MedicineGroup - Multi-Specialty