Provider Demographics
NPI:1902170830
Name:ALLIED IMAGING PROVIDERS
Entity Type:Organization
Organization Name:ALLIED IMAGING PROVIDERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SEYED
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHROKNI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-859-0400
Mailing Address - Street 1:24301 PASEO DE VALENCIA
Mailing Address - Street 2:STE 100
Mailing Address - City:LAGUNA WOODS
Mailing Address - State:CA
Mailing Address - Zip Code:92637-3142
Mailing Address - Country:US
Mailing Address - Phone:949-583-9264
Mailing Address - Fax:949-269-9139
Practice Address - Street 1:24301 PASEO DE VALENCIA
Practice Address - Street 2:STE 100
Practice Address - City:LAGUNA WOODS
Practice Address - State:CA
Practice Address - Zip Code:92637-3142
Practice Address - Country:US
Practice Address - Phone:949-583-9264
Practice Address - Fax:949-269-9139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-23
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology