Healthcare Provider Details

I. General information

NPI: 1477932689
Provider Name (Legal Business Name): PIONEER DIAGNOSTIC & IMAGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2015
Last Update Date: 07/12/2021
Certification Date: 06/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

939 N PLUM GROVE RD SUITE A
SCHAUMBURG IL
60173-5183
US

IV. Provider business mailing address

1050 MURRIETA BLVD STE 288
LIVERMORE CA
94550-4111
US

V. Phone/Fax

Practice location:
  • Phone: 877-470-7531
  • Fax:
Mailing address:
  • Phone: 877-470-7531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SAMEENA ISRAR
Title or Position: CHAIRMAN
Credential:
Phone: 925-413-0780