MEDICARE: CALIFORNIA PACIFIC ADVANCED IMAGING

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	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DA2436	OTHER	CA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912950676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALIFORNIA PACIFIC ADVANCED IMAGING

Provider Business Mailing Address
First Line	:	PO BOX 6102
Second Line	:
City	:	NOVATO
State	:	CA
Zip	:	94948-6102
Country	:	US
Telephone Number	:	415-884-9125
Fax Number	:

Provider Business Practice Location Address
First Line	:	2351 CLAY ST STE 100
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94115-1931
Country	:	US
Telephone Number	:	415-600-3143
Fax Number	:	415-600-3123

Authorized Official
Title or Position	:	BOARD MEMBER
Name	:	DR. AVANTI AMBEKAR
Credential	:	MD
Telephone Number	:	153-084-8904

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	06/13/2024

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Directions to “CALIFORNIA PACIFIC ADVANCED IMAGING ” Practice Location

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