Provider Demographics
NPI:1144436601
Name:RADIOLOGY SPECIALTY IMAGING
Entity type:Organization
Organization Name:RADIOLOGY SPECIALTY IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:JANICE
Authorized Official - Last Name:LABEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-473-7773
Mailing Address - Street 1:2201 E WILLOW ST STE D206
Mailing Address - Street 2:
Mailing Address - City:SIGNAL HILL
Mailing Address - State:CA
Mailing Address - Zip Code:90755-2148
Mailing Address - Country:US
Mailing Address - Phone:562-437-7773
Mailing Address - Fax:562-437-1440
Practice Address - Street 1:1050 E WARDLOW RD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-4736
Practice Address - Country:US
Practice Address - Phone:562-437-7773
Practice Address - Fax:562-437-1440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG10742174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty