Provider Demographics
NPI:1144507906
Name:NEXTIMAGE HOLDINGS LLC
Entity type:Organization
Organization Name:NEXTIMAGE HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF INFORMATION OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-847-9185
Mailing Address - Street 1:3390 CARMEL MOUNTAIN RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-1002
Mailing Address - Country:US
Mailing Address - Phone:858-847-9185
Mailing Address - Fax:858-847-9135
Practice Address - Street 1:3390 CARMEL MOUNTAIN RD
Practice Address - Street 2:SUITE 150
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1002
Practice Address - Country:US
Practice Address - Phone:858-847-9185
Practice Address - Fax:858-847-9135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)