Provider Demographics
NPI:1588912299
Name:RADIOLOGY TECHNOLOGIES, INC
Entity type:Organization
Organization Name:RADIOLOGY TECHNOLOGIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NASSOROLLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SANAVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-231-1402
Mailing Address - Street 1:521 JOBE HILL DRIVE
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081
Mailing Address - Country:US
Mailing Address - Phone:818-231-1402
Mailing Address - Fax:818-609-7693
Practice Address - Street 1:18617 CLARK STREET, NO. 6
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3432
Practice Address - Country:US
Practice Address - Phone:818-231-1402
Practice Address - Fax:818-609-7693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARHT2074247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Single Specialty