Provider Demographics
NPI:1427476357
Name:DISCOVERY RADIOLOGY, INC
Entity type:Organization
Organization Name:DISCOVERY RADIOLOGY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:SOLAKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-275-2369
Mailing Address - Street 1:1200 S BRAND BLVD
Mailing Address - Street 2:803
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-2641
Mailing Address - Country:US
Mailing Address - Phone:818-275-2369
Mailing Address - Fax:
Practice Address - Street 1:7111 WINNETKA AVE
Practice Address - Street 2:16
Practice Address - City:WINNETKA
Practice Address - State:CA
Practice Address - Zip Code:91306-3672
Practice Address - Country:US
Practice Address - Phone:818-275-2369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-28
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty