Provider Demographics
NPI:1962577981
Name:NATIONAL STANDUP IMAGING, LLC
Entity type:Organization
Organization Name:NATIONAL STANDUP IMAGING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-964-0674
Mailing Address - Street 1:5757 WILSHIRE BLVD
Mailing Address - Street 2:STE 8
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-5810
Mailing Address - Country:US
Mailing Address - Phone:323-964-0674
Mailing Address - Fax:323-456-0139
Practice Address - Street 1:5757 WILSHIRE BLVD
Practice Address - Street 2:STE 8
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-5810
Practice Address - Country:US
Practice Address - Phone:323-964-0674
Practice Address - Fax:323-456-0139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATG461Medicare ID - Type Unspecified