Provider Demographics
NPI:1497504518
Name:GAMMA DIAGNOSTIC INC
Entity type:Organization
Organization Name:GAMMA DIAGNOSTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GRIGOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAKELIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-540-8150
Mailing Address - Street 1:14126 SHERMAN WAY STE 201
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-5631
Mailing Address - Country:US
Mailing Address - Phone:323-540-8150
Mailing Address - Fax:
Practice Address - Street 1:14126 SHERMAN WAY STE 201
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-5631
Practice Address - Country:US
Practice Address - Phone:323-540-8150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile