MEDICARE: RADIANT MOBILE IMAGING, 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	2471C3402X	Radiography Radiologic Technologist
2	335V00000X	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier

General Provider Information

NPI Number	:	1891649968
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RADIANT MOBILE IMAGING, LLC

Provider Business Mailing Address
First Line	:	1705 FERNANDES ST
Second Line	:
City	:	MODESTO
State	:	CA
Zip	:	95355-1547
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1705 FERNANDES ST
Second Line	:
City	:	MODESTO
State	:	CA
Zip	:	95355-1547
Country	:	US
Telephone Number	:	209-222-8812
Fax Number	:

Authorized Official
Title or Position	:	CO-CEO
Name	:	MELEALOHA REDOBLE
Credential	:
Telephone Number	:	209-222-8812

Provider Enumeration Date	:	02/24/2026
Last Update Date	:	04/06/2026

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