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General NPI Number Information
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NPI Number | 1053538660
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Entity Type | Organization
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Legal Business Name | SANTA CLARA IMAGING CENTER, LLC
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 09/28/2012
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Provider Practice Location Address
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Address Line | 1825 CIVIC CENTER DRIVE 1
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City | SANTA CLARA
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State | CA
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Zip | 95050
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Country | US
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Telephone | 408-296-5555
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Fax | 408-296-5556
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Provider Business Mailing Address
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Address Line | 1825 CIVIC CENTER DRIVE 1
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City | SANTA CLARA
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State | CA
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Zip | 95050
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Country | US
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Telephone | 408-296-5555
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Fax | 408-296-5556
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | MR. REZA HASHEMIEH
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Credential |
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Telephone | 408-296-5555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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