1336598093 NPI number — MAXVIEW, INC

Table of content: (NPI 1336598093)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336598093 NPI number — MAXVIEW, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MAXVIEW, 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:
ROSEVILLE DIAGNOSTIC 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:
1336598093
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/03/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 320576
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOS GATOS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95032-0109
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-691-4401
Provider Business Mailing Address Fax Number:
916-691-4402

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1830 SIERRA GARDENS DR
Provider Second Line Business Practice Location Address:
SUITE 30
Provider Business Practice Location Address City Name:
ROSEVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95661-2942
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-691-4401
Provider Business Practice Location Address Fax Number:
916-691-4402
Provider Enumeration Date:
06/03/2016

Additional Information

Authorized Official

Authorized Official Last Name:
CHOE
Authorized Official First Name:
JOEL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
916-691-4401

Provider Taxonomy Codes

  • Taxonomy code: 261QR0200X , with the licence number:  00834092 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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