Healthcare Provider Details

I. General information

NPI: 1801031422
Provider Name (Legal Business Name): MV IMAGING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2008
Last Update Date: 12/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16415 COLORADO AVE SUITE 402
PARAMOUNT CA
90723-5035
US

IV. Provider business mailing address

16415 COLORADO AVE SUITE 402
PARAMOUNT CA
90723-5035
US

V. Phone/Fax

Practice location:
  • Phone: 562-633-6456
  • Fax: 562-633-6459
Mailing address:
  • Phone: 562-633-6456
  • Fax: 562-633-6459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberA45996
License Number StateCA

VIII. Authorized Official

Name: MS. MARTHA LORENA VEGA
Title or Position: ADMINISTRATOR
Credential:
Phone: 562-633-6456