Healthcare Provider Details

I. General information

NPI: 1316252117
Provider Name (Legal Business Name): IMAGING CONSULTANTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2010
Last Update Date: 07/24/2023
Certification Date: 07/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 CAREW ST
SPRINGFIELD MA
01104-2377
US

IV. Provider business mailing address

18201 VON KARMAN AVE STE 600
IRVINE CA
92612-1176
US

V. Phone/Fax

Practice location:
  • Phone: 866-245-5995
  • Fax:
Mailing address:
  • Phone: 949-242-5592
  • Fax:

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: TONI COOPER
Title or Position: DIRECTOR OF CREDENTIALING
Credential:
Phone: 754-206-6198