Provider Demographics
NPI:1902160799
Name:WALKER STREET IMAGING CARE, INC.
Entity Type:Organization
Organization Name:WALKER STREET IMAGING CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:PRINCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-929-1836
Mailing Address - Street 1:10601 WALKER ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-4733
Mailing Address - Country:US
Mailing Address - Phone:714-656-2130
Mailing Address - Fax:714-252-8484
Practice Address - Street 1:10601 WALKER ST
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-4733
Practice Address - Country:US
Practice Address - Phone:714-656-2130
Practice Address - Fax:714-252-8484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-27
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty