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General NPI Number Information
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NPI Number | 1952322182
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Entity Type | Organization
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Legal Business Name | GARDEN GROVE MRI CENTER
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 10/05/2007
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Provider Practice Location Address
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Address Line | 12555 GARDEN GROVE BLVD SUITE 103
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City | GARDEN GROVE
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State | CA
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Zip | 92843-1902
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Country | US
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Telephone | 714-545-9441
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Fax |
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Provider Business Mailing Address
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Address Line | 1220 HEMLOCK WAY SUITE 106
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City | SANTA ANA
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State | CA
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Zip | 92707-3650
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | PATRICK SEIN
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Credential |
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Telephone | 714-545-9441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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