Healthcare Provider Details

I. General information

NPI: 1073897807
Provider Name (Legal Business Name): SCANQUEST IMAGING CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2011
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16415 COLORADO AVE STE 402
PARAMOUNT CA
90723-5052
US

IV. Provider business mailing address

9457 OAK ST
BELLFLOWER CA
90706-5205
US

V. Phone/Fax

Practice location:
  • Phone: 562-217-1244
  • Fax: 562-633-6459
Mailing address:
  • Phone: 888-517-1326
  • Fax: 562-633-6459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. JESSE JOSE MINJARES JR.
Title or Position: VICE PRESIDENT
Credential:
Phone: 562-217-1244