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General NPI Number Information
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NPI Number | 1205905353
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Entity Type | Organization
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Legal Business Name | IMPERIAL VALLEY MEDICAL IMAGING SERVICES INC
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1600 S IMPERIAL AVE SUITE 17
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City | EL CENTRO
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State | CA
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Zip | 92243-4242
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Country | US
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Telephone | 760-352-9808
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 889
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City | WOODLAND HILLS
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State | CA
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Zip | 91365-0889
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Country | US
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Telephone | 818-597-3800
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Fax | 818-879-8272
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Authorized Official
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Title or Position | ACTIVE PARTNER OWNER MANAGER
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Name | MR. JAMES ROBERT MCCALL
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Credential | RT
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Telephone | 760-352-9808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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