MEDICARE: MEDICAL OUTSOURCING SERVICES, 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	261QR0208X	Mobile Radiology Clinic/Center

General Provider Information

NPI Number	:	1679727234
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL OUTSOURCING SERVICES, LLC

Provider Business Mailing Address
First Line	:	100 BAYVIEW CIR
Second Line	:	SUITE 400
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-2983
Country	:	US
Telephone Number	:	949-242-5384
Fax Number	:	480-212-8589

Provider Business Practice Location Address
First Line	:	324 EMERSON RD
Second Line	:
City	:	HIGH RIDGE
State	:	MO
Zip	:	63049-2542
Country	:	US
Telephone Number	:	636-677-1800
Fax Number	:

Authorized Official
Title or Position	:	EXEC VP & CFO
Name	:	HOWARD AIHARA
Credential	:
Telephone Number	:	800-544-3215

Provider Enumeration Date	:	11/10/2008
Last Update Date	:	12/12/2014

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