Healthcare Provider Details
I. General information
NPI: 1164475174
Provider Name (Legal Business Name): OPEN AIR MRI CENTERS MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/19/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6386 ALVARADO CT 107
SAN DIEGO CA
92120-4905
US
IV. Provider business mailing address
PO BOX 910514
SAN DIEGO CA
92191-0514
US
V. Phone/Fax
- Phone: 619-229-2299
- Fax: 619-229-2288
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JON
M
ROBINS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 619-229-2299