Healthcare Provider Details

I. General information

NPI: 1033163548
Provider Name (Legal Business Name): MAGNETIC IMAGING MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 10/18/2021
Certification Date: 10/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8515 FLORENCE AVE STE 100
DOWNEY CA
90240-4043
US

IV. Provider business mailing address

DEPT. WS200 PO BOX 509015
SAN DIEGO CA
92150-9015
US

V. Phone/Fax

Practice location:
  • Phone: 561-904-1340
  • Fax: 562-869-8606
Mailing address:
  • Phone: 866-674-7933
  • Fax: 952-513-6880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOEL B LEVINE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 561-904-1340