MEDICARE: NATIONAL INTRAOPERATIVE MONITORING INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	247200000X	Other Technician

General Provider Information

NPI Number	:	1144538059
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL INTRAOPERATIVE MONITORING INC

Provider Business Mailing Address
First Line	:	PO BOX 4363
Second Line	:
City	:	CERRITOS
State	:	CA
Zip	:	90703-4363
Country	:	US
Telephone Number	:	714-443-3201
Fax Number	:	714-443-3202

Provider Business Practice Location Address
First Line	:	5584 N PARAMOUNT BLVD STE 202
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-5133
Country	:	US
Telephone Number	:	714-443-3201
Fax Number	:	714-443-3202

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARY AVILES
Credential	:
Telephone Number	:	714-443-3201

Provider Enumeration Date	:	09/14/2010
Last Update Date	:	04/09/2012

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