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General NPI Number Information
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NPI Number | 1639363856
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Entity Type | Organization
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Legal Business Name | INLAND IMAGING SERVICES
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Dates
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Enumeration Date | 08/30/2007
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Last Update Date | 08/30/2007
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Provider Practice Location Address
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Address Line | 13330 BLOOMFIELD AVE SUITE 114
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City | NORWALK
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State | CA
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Zip | 90650-3251
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Country | US
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Telephone | 562-674-2911
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Fax | 562-674-2917
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Provider Business Mailing Address
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Address Line | 29822 SEA BREEZE WAY
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City | MENIFEE
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State | CA
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Zip | 92584-7981
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Country | US
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Telephone | 303-944-3764
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. LEO BACA
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Credential | RPA
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Telephone | 303-944-3764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247100000X
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Taxonomy Name | Radiologic Technologist
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License Number | 05CO1119
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License Number State | CA
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