Provider Demographics
NPI:1063252328
Name:PHYSICIANS CHOICE MOBILE IMAGING
Entity type:Organization
Organization Name:PHYSICIANS CHOICE MOBILE IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CASHMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:LUKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-666-5323
Mailing Address - Street 1:4274 N BLACKSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-1900
Mailing Address - Country:US
Mailing Address - Phone:800-666-5323
Mailing Address - Fax:
Practice Address - Street 1:4274 N BLACKSTONE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-1900
Practice Address - Country:US
Practice Address - Phone:800-666-5323
Practice Address - Fax:844-646-2020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-25
Last Update Date:2024-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QR0207XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile Mammography
No335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier