Healthcare Provider Details

I. General information

NPI: 1164584041
Provider Name (Legal Business Name): ALLIANCE HEALTHCARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 07/24/2023
Certification Date: 07/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 BUHNE ST
EUREKA CA
95501-3237
US

IV. Provider business mailing address

8300 W SUNRISE BLVD
PLANTATION FL
33322-5406
US

V. Phone/Fax

Practice location:
  • Phone: 707-445-8121
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number6640-30
License Number StateCA

VIII. Authorized Official

Name: LAURA KASSA
Title or Position: SR VICE PRESIDENT
Credential:
Phone: 904-300-2777