Healthcare Provider Details

I. General information

NPI: 1043243702
Provider Name (Legal Business Name): SAN JOSE IMAGING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

361 SOUTH MONROE ST
SAN JOSE CA
95128
US

IV. Provider business mailing address

361 SOUTH MONROE ST
SAN JOSE CA
95128
US

V. Phone/Fax

Practice location:
  • Phone: 408-556-1500
  • Fax: 408-985-6349
Mailing address:
  • Phone: 408-556-1500
  • Fax: 408-985-6349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471M1202X
TaxonomyMagnetic Resonance Imaging Radiologic Technologist
License Number
License Number StateCA

VIII. Authorized Official

Name: PRISCILLA GARCIA
Title or Position: OFFICE MANAGER
Credential:
Phone: 408-985-6334