1568480028 NPI number — OPEN SYSTEM MRI 1 A CALIFORNIA LIMITED PARTNERSHIP

Table of content: (NPI 1568480028)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568480028 NPI number — OPEN SYSTEM MRI 1 A CALIFORNIA LIMITED PARTNERSHIP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OPEN SYSTEM MRI 1 A CALIFORNIA LIMITED PARTNERSHIP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
OPEN SYSTEM IMAGING
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568480028
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/31/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1595
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RANCHO MIRAGE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92270
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-346-6413
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1401 N TUSTIN AVE
Provider Second Line Business Practice Location Address:
170
Provider Business Practice Location Address City Name:
SANTA ANA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92705-8644
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-543-7643
Provider Business Practice Location Address Fax Number:
714-480-7829
Provider Enumeration Date:
07/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BISHOP
Authorized Official First Name:
KENNETH
Authorized Official Middle Name:
O
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
760-346-6413

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: TD004 . This is a "MEDICARE PTAN" identifier . This identifiers is of the category "OTHER".




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