Provider Demographics
NPI:1538336755
Name:SOUTHERN CALIFORNIA IMAGING CENTER, LLC
Entity type:Organization
Organization Name:SOUTHERN CALIFORNIA IMAGING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:B
Authorized Official - Last Name:GARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-868-3751
Mailing Address - Street 1:13132 STUDEBAKER RD STE A
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-2573
Mailing Address - Country:US
Mailing Address - Phone:562-929-6896
Mailing Address - Fax:562-929-7216
Practice Address - Street 1:13132 STUDEBAKER RD STE A
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-2573
Practice Address - Country:US
Practice Address - Phone:562-929-6896
Practice Address - Fax:562-929-7216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center