Healthcare Provider Details

I. General information

NPI: 1629265806
Provider Name (Legal Business Name): SILICON VALLEY DIAGNOSTIC IMAGING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2007
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 GRANT RD
MOUNTAIN VIEW CA
94040-4302
US

IV. Provider business mailing address

PO BOX 85386
CHICAGO IL
60689-5386
US

V. Phone/Fax

Practice location:
  • Phone: 650-940-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: KAREN VAUGHN
Title or Position: AO
Credential:
Phone: 629-317-1465