Healthcare Provider Details

I. General information

NPI: 1952345290
Provider Name (Legal Business Name): MEDICAL IMAGING ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9033 WILSHIRE BLVD 305
BEVERLY HILLS CA
90211-1837
US

IV. Provider business mailing address

9033 WILSHIRE BLVD 305
BEVERLY HILLS CA
90211-1837
US

V. Phone/Fax

Practice location:
  • Phone: 310-278-0656
  • Fax: 310-278-7716
Mailing address:
  • Phone: 310-278-0656
  • Fax: 310-278-7716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberC32168
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License NumberC32168
License Number StateCA

VIII. Authorized Official

Name: JAMES HOWARD PRITCHARD
Title or Position: OWNER
Credential: M.D.
Phone: 310-278-0656