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General NPI Number Information
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NPI Number | 1841301231
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Entity Type | Organization
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Legal Business Name | MEDIZEN ADVANCED IMAGING INC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 01/08/2014
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Provider Practice Location Address
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Address Line | 17305 BROOKHURST ST
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-3721
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Country | US
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Telephone | 714-968-8998
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Fax | 714-968-8628
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Provider Business Mailing Address
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Address Line | 17305 BROOKHURST ST
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-3721
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Country | US
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Telephone | 714-968-8998
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Fax | 714-968-8628
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Authorized Official
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Title or Position | MEDICAL DIRECTOR PRESIDENT
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Name | DR. DAVID T MAI
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Credential | M.D.
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Telephone | 714-968-8998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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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 | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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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 | 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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Taxonomy #4
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | G63683
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License Number State | CA
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