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NPI Code Detail

MEDICARE: ALLIANCE MEDICAL CONSULTING, LLC

MEDICARE: ALLIANCE MEDICAL CONSULTING, 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
1293D00000XPhysiological Laboratory
2335V00000XPortable X-ray and/or Other Portable Diagnostic Imaging SupplierCA

General Provider Information

NPI Number : 1760989347
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALLIANCE MEDICAL CONSULTING, LLC
Provider Business Mailing Address
First Line : 7450 CHATEAU RIDGE LN
Second Line :
City : RIVERSIDE
State : CA
Zip : 92506-7545
Country : US
Telephone Number : 951-858-5439
Fax Number : 800-343-2107
Provider Business Practice Location Address
First Line : 3500 LENOX RD NE STE 1500
Second Line :
City : ATLANTA
State : GA
Zip : 30326-4231
Country : US
Telephone Number : 833-822-0010
Fax Number : 800-343-2107
Authorized Official
Title or Position : OWNER
Name : MR. GARY WARREN GILLMAN JR.
Credential :
Telephone Number : 833-822-0100
Provider Enumeration Date : 04/10/2018
Last Update Date : 03/20/2019

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Directions to “ALLIANCE MEDICAL CONSULTING, LLC ” Practice Location

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