Provider Demographics
NPI:1154377661
Name:MEDICAL IMAGING PARTNERS
Entity type:Organization
Organization Name:MEDICAL IMAGING PARTNERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:MORRISSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-446-0080
Mailing Address - Street 1:638 W DUARTE RD
Mailing Address - Street 2:#2
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-7616
Mailing Address - Country:US
Mailing Address - Phone:626-446-0080
Mailing Address - Fax:626-446-0262
Practice Address - Street 1:638 W DUARTE RD
Practice Address - Street 2:#2
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-7616
Practice Address - Country:US
Practice Address - Phone:626-446-0080
Practice Address - Fax:626-446-0262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ612542OtherBLUE SHIELD
CA470000966OtherMEDICARE RAILROAD