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General NPI Number Information
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NPI Number | 1235689175
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Entity Type | Organization
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Legal Business Name | SHIN IMAGING LLC
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Dates
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Enumeration Date | 10/04/2016
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1955 SUNNYCREST DR STE 110
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City | FULLERTON
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State | CA
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Zip | 92835-3653
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Country | US
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Telephone | 310-995-6689
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Fax |
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Provider Business Mailing Address
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Address Line | 1955 SUNNY CREST DR STE 110
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City | FULLERTON
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State | CA
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Zip | 92835-3653
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Country | US
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Telephone | 714-578-8882
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Fax | 714-578-8886
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHARLES J MALONEY
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Credential |
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Telephone | 310-995-6689
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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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