MEDICARE: MILLENNIUM DIAGNOSTIC IMAGING SERVICE INC

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	293D00000X	Physiological Laboratory
2	335V00000X	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier

General Provider Information

NPI Number	:	1992017057
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILLENNIUM DIAGNOSTIC IMAGING SERVICE INC

Provider Business Mailing Address
First Line	:	1305 S COURSON DR
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92804-4721
Country	:	US
Telephone Number	:	877-277-7848
Fax Number	:	855-464-4936

Provider Business Practice Location Address
First Line	:	1305 S. COURSON DRIVE
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92804-4721
Country	:	US
Telephone Number	:	877-277-7848
Fax Number	:	855-464-4936

Authorized Official
Title or Position	:	CEO
Name	:	MR. SUKHPAL SINGH KHUNKHUN
Credential	:
Telephone Number	:	877-277-7848

Provider Enumeration Date	:	07/06/2010
Last Update Date	:	03/11/2026

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Directions to “MILLENNIUM DIAGNOSTIC IMAGING SERVICE INC ” Practice Location

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