Provider Demographics
NPI:1487543385
Name:LOS ANGELES BROADWAY RADIOLOGY PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:LOS ANGELES BROADWAY RADIOLOGY PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAUSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:310-779-8907
Mailing Address - Street 1:231 W VERNON AVE STE 111
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90037-2778
Mailing Address - Country:US
Mailing Address - Phone:310-779-8907
Mailing Address - Fax:
Practice Address - Street 1:231 W VERNON AVE STE 111
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90037-2778
Practice Address - Country:US
Practice Address - Phone:310-779-8907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty