=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932302171
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANATIONAL MRI CENTERS, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/06/2007
-----------------------------------------------------
Last Update Date | 02/11/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 180 OTAY LAKES RD #108
-----------------------------------------------------
City | BONITA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91902-2443
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-628-5674
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | P.O. BOX 2798
-----------------------------------------------------
City | GARDEN GROVE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92842
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-628-5674
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MR. MIR HAUSEN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 877-628-5674
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM1200X
-----------------------------------------------------
Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------