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General NPI Number Information
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NPI Number | 1376209940
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Entity Type | Organization
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Legal Business Name | NORTH OC IMAGING JV, LLC
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Dates
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Enumeration Date | 11/09/2021
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 15855 POMONA RINCON ROAD STE 101
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City | CHINO HILLS
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State | CA
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Zip | 91709
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Country | US
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Telephone | 714-578-8882
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Fax |
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Provider Business Mailing Address
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Address Line | 15855 POMONA RINCON ROAD STE 101
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City | CHINO HILLS
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State | CA
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Zip | 91709
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PAYOR RELATIONS
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Name | MARTIN KELLEY
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Credential |
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Telephone | 404-392-9903
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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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