Healthcare Provider Details

I. General information

NPI: 1003140419
Provider Name (Legal Business Name): ALLIANCE HEALTHCARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2009
Last Update Date: 10/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 W OLD KEY DR
PERU IN
46970-9057
US

IV. Provider business mailing address

100 BAYVIEW CIR SUITE 400
NEWPORT BEACH CA
92660-2983
US

V. Phone/Fax

Practice location:
  • Phone: 765-472-2124
  • Fax:
Mailing address:
  • Phone: 949-242-5384
  • Fax: 602-773-3747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HOWARD AIHARA
Title or Position: EXEC VP & CFO
Credential:
Phone: 800-544-3215