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NPI Code Detail

MEDICARE: LAGUNA NIGUEL MRI INC.

MEDICARE: LAGUNA NIGUEL MRI 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
1293D00000XPhysiological Laboratory

General Provider Information

NPI Number : 1154427672
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAGUNA NIGUEL MRI INC.
Provider Business Mailing Address
First Line : 4200 E PACIFIC COAST HWY
Second Line :
City : LONG BEACH
State : CA
Zip : 90804-2112
Country : US
Telephone Number : 562-498-6322
Fax Number : 562-597-0978
Provider Business Practice Location Address
First Line : 4200 E PACIFIC COAST HWY
Second Line :
City : LONG BEACH
State : CA
Zip : 90804-2112
Country : US
Telephone Number : 562-498-6322
Fax Number : 562-597-0978
Authorized Official
Title or Position : COO
Name : LESLIE G. WEBER
Credential :
Telephone Number : 858-455-7127
Provider Enumeration Date : 09/15/2006
Last Update Date : 08/22/2020

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Directions to “LAGUNA NIGUEL MRI INC. ” Practice Location

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