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General NPI Number Information
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NPI Number | 1003412982
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Entity Type | Organization
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Legal Business Name | MAXIMAL INTENSITY PROJECTION LLC
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Dates
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Enumeration Date | 12/07/2020
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Last Update Date | 12/07/2020
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Provider Practice Location Address
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Address Line | 12191 FRONT ST
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City | NORWALK
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State | CA
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Zip | 90650-4203
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Country | US
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Telephone | 562-920-5292
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Fax | 562-920-5847
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Provider Business Mailing Address
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Address Line | 38 CLEAR CRK
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City | IRVINE
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State | CA
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Zip | 92620-1272
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Country | US
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Telephone | 949-293-2662
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Fax | 949-266-5589
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Authorized Official
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Title or Position | MEDICAL DIRECTOR/PRESIDENT
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Name | MR. SHERIEF GAMIE
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Credential | MD, PHD
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Telephone | 949-293-2662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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