MEDICARE: ALLIANCE HEALTHCARE SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center

General Provider Information

NPI Number	:	1982919411
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIANCE HEALTHCARE SERVICES INC

Provider Business Mailing Address
First Line	:	100 BAYVIEW CIR
Second Line	:	SUITE 400
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-2983
Country	:	US
Telephone Number	:	800-544-3215
Fax Number	:

Provider Business Practice Location Address
First Line	:	4520 E GRANT RD STE 100
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-2637
Country	:	US
Telephone Number	:	520-289-8089
Fax Number	:	520-289-8090

Authorized Official
Title or Position	:	SVP CORPORATE FINANCE
Name	:	NICHOLAS A POAN
Credential	:
Telephone Number	:	949-242-5321

Provider Enumeration Date	:	08/09/2010
Last Update Date	:	02/09/2012

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