1821234899 NPI number — CALIFORNIA MEDICAL IMAGING ASSOCIATES, INC

Table of content: (NPI 1821234899)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821234899 NPI number — CALIFORNIA MEDICAL IMAGING ASSOCIATES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CALIFORNIA MEDICAL IMAGING ASSOCIATES, INC
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:
TULARE IMAGING ASSOCIATES, A MEDICAL CORPORATION
Provider Other Organization Name Type Code:
4
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:
1821234899
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/26/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2527 CRANBERRY HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WAREHAM
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02571-1046
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-841-5200
Provider Business Mailing Address Fax Number:
508-273-1241

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3610 W PACKWOOD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VISALIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93277-5010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-713-6050
Provider Business Practice Location Address Fax Number:
559-713-6321
Provider Enumeration Date:
12/23/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MONIZ
Authorized Official First Name:
JESSE
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
800-841-5200

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)





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