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General NPI Number Information
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NPI Number | 1487040770
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Entity Type | Organization
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Legal Business Name | MAGNETIC IMAGING AFFILIATES, LLC
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Dates
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Enumeration Date | 04/13/2015
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Last Update Date | 07/16/2015
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Provider Practice Location Address
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Address Line | 5730 TELEGRAPH AVE
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City | OAKLAND
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State | CA
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Zip | 94609-1710
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Country | US
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Telephone | 510-204-2744
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Fax | 510-658-1277
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Provider Business Mailing Address
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Address Line | 2450 ASHBY AVE
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City | BERKELEY
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State | CA
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Zip | 94705-2067
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Country | US
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Telephone | 415-600-7755
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | JOHN B. GATES
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Credential |
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Telephone | 415-600-7755
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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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