1487620118 NPI number — INSIGHT HEALTH CORP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487620118 NPI number — INSIGHT HEALTH CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INSIGHT HEALTH CORP
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:
Provider Other Organization Name Type Code:
6
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:
1487620118
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/10/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26250 ENTERPRISE CT
Provider Second Line Business Mailing Address:
STE 100 LEGAL DEPT
Provider Business Mailing Address City Name:
LAKE FOREST
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92630-8406
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-282-6000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3655 ALAMO ST
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
SIMI VALLEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93063-2187
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-520-0222
Provider Business Practice Location Address Fax Number:
805-520-0520
Provider Enumeration Date:
02/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BLANK
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
R.
Authorized Official Title or Position:
EXECUTIVE VICE PRESIDENT, RCM
Authorized Official Telephone Number:
949-282-6000

Provider Taxonomy Codes

  • Taxonomy code: 293D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: EXE70132F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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