1447241302 NPI number — INVIEW IMAGING MEDICAL CORPORATION

Table of content: (NPI 1447241302)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447241302 NPI number — INVIEW IMAGING MEDICAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INVIEW IMAGING MEDICAL CORPORATION
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:
1447241302
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/29/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3450 HILLCREST AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANTIOCH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94531-8238
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
925-757-2100
Provider Business Mailing Address Fax Number:
925-757-2101

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
39465 PASEO PADRE PKWY
Provider Second Line Business Practice Location Address:
SUITE 1000
Provider Business Practice Location Address City Name:
FREMONT
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94538-5347
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-490-0961
Provider Business Practice Location Address Fax Number:
510-490-0971
Provider Enumeration Date:
10/31/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SILBERMAN
Authorized Official First Name:
JODI
Authorized Official Middle Name:
Authorized Official Title or Position:
CREDENTIALING & BILLING MANAGER
Authorized Official Telephone Number:
510-490-0961

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  G83634 , 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)

  • Identifier: ZZZ02851Z , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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