Provider Demographics
NPI:1336212505
Name:PRIME ULTRASOUND SERVICES INC
Entity type:Organization
Organization Name:PRIME ULTRASOUND SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:MARGULYAN
Authorized Official - Suffix:
Authorized Official - Credentials:ARDMS
Authorized Official - Phone:818-788-7877
Mailing Address - Street 1:16200 VENTURA BLVD
Mailing Address - Street 2:#402
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436
Mailing Address - Country:US
Mailing Address - Phone:818-788-7877
Mailing Address - Fax:818-788-7833
Practice Address - Street 1:16200 VENTURA BLVD
Practice Address - Street 2:#402
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436
Practice Address - Country:US
Practice Address - Phone:818-788-7877
Practice Address - Fax:818-788-7833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATG229Medicare ID - Type Unspecified