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General NPI Number Information
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NPI Number | 1508363110
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Entity Type | Organization
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Legal Business Name | NORTH VALLEY MRI IMAGING INC
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Dates
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Enumeration Date | 04/10/2018
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Last Update Date | 04/10/2018
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Provider Practice Location Address
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Address Line | 6 CENTERPOINTE DR STE 700
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City | LA PALMA
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State | CA
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Zip | 90623-2545
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Country | US
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Telephone | 213-270-4467
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 847
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City | CYPRESS
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State | CA
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Zip | 90630-0847
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Country | US
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Telephone | 213-270-4467
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Fax | 213-419-5008
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Authorized Official
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Title or Position | PRESIDENT
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Name | STUART EDWIN STRAUSBERG
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Credential | DO
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Telephone | 213-270-4467
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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 | 20A63638
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License Number State | CA
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