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General NPI Number Information
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NPI Number | 1528566890
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Entity Type | Organization
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Legal Business Name | ASSURED IMAGING WOMEN'S WELLNESS OF SOUTHERN ARIZONA, LLC
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Dates
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Enumeration Date | 01/31/2018
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 3901 ARLINGTON HIGHLANDS BLVD STE 200
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City | ARLINGTON
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State | TX
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Zip | 76018-6050
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Country | US
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Telephone | 888-233-6121
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Fax |
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Provider Business Mailing Address
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Address Line | 7717 N HARTMAN LN
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City | TUCSON
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State | AZ
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Zip | 85743-5800
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Country | US
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Telephone | 888-233-6121
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JIN KIM
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Credential |
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Telephone | 312-774-8828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0207X
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Taxonomy Name | Mobile Mammography Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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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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