Medical Imaging Center Of Southern California
Radiology, Diagnostic Radiology in Santa Monica, CA. Organization (NPI-2).
NPI number1700907433
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1700907433
- Entity type
- Organization (NPI-2)
- Legal business name
- Medical Imaging Center Of Southern California
- Organization subpart
- No
- Enumeration date
- Apr 2, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0202X | Radiology, Diagnostic Radiology | W13479 | CA | Yes |
Practice location
2827 Wilshire BlvdSanta Monica, CA 90403-4801
Phone 310-829-9788 · Fax 310-453-1576
Mailing address
2827 Wilshire BlvdSanta Monica, CA 90403-4801
Phone 310-829-9788 · Fax 310-453-1576
Authorized official
Dairzette Layne
Billing Manager
3108299788
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