Provider Demographics
NPI:1861431215
Name:A & T IMAGING INC
Entity type:Organization
Organization Name:A & T IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHALETSKAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-687-3603
Mailing Address - Street 1:16200 VENTURA BLVD
Mailing Address - Street 2:SUITE 318
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2205
Mailing Address - Country:US
Mailing Address - Phone:818-687-3603
Mailing Address - Fax:818-986-0654
Practice Address - Street 1:16200 VENTURA BLVD
Practice Address - Street 2:SUITE 318
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2205
Practice Address - Country:US
Practice Address - Phone:818-687-3603
Practice Address - Fax:818-986-0654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225B00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPulmonary Function TechnologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATG573Medicare PIN