MEDICARE: PREFERRED MRI, LLC

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	335V00000X	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier

General Provider Information

NPI Number	:	1568645620
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREFERRED MRI, LLC

Provider Business Mailing Address
First Line	:	6416 RESIDENCIA
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-9052
Country	:	US
Telephone Number	:	909-677-9207
Fax Number	:

Provider Business Practice Location Address
First Line	:	6416 RESIDENCIA
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-9052
Country	:	US
Telephone Number	:	909-677-9207
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	TANYA MORELAND
Credential	:
Telephone Number	:	909-677-9207

Provider Enumeration Date	:	12/12/2007
Last Update Date	:	12/12/2007

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