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General NPI Number Information
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NPI Number | 1689794224
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Entity Type | Organization
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Legal Business Name | COMMUNITY IMAGING GROUP
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9530 IMPERIAL HWY SUITE L
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City | DOWNEY
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State | CA
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Zip | 90242-3041
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Country | US
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Telephone | 562-803-9477
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Fax | 562-803-9596
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Provider Business Mailing 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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Authorized Official
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Title or Position | OWNER
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Name | JESSE Z MEJIA
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Credential | RPA
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Telephone | 562-674-2911
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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 | 06CA1109
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License Number State | CA
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