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General NPI Number Information
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NPI Number | 1255016333
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Entity Type | Organization
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Legal Business Name | PREMIER IMAGING SOLUTIONS SOCAL LLC
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Dates
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Enumeration Date | 06/16/2023
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Last Update Date | 06/16/2023
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Provider Practice Location Address
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Address Line | 23297 S POINTE DR STE 100
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-1491
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Country | US
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Telephone | 877-211-4523
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Fax |
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Provider Business Mailing Address
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Address Line | 3440 N 16TH ST STE 200
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City | PHOENIX
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State | AZ
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Zip | 85016-7125
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Country | US
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Telephone | 605-484-0188
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Fax |
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Authorized Official
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Title or Position | QUALITY AND COMPLIANCE DIRECTOR
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Name | JAMIE WOOD
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Credential |
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Telephone | 605-484-0188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number |
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License Number State |
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