Provider Demographics
NPI:1154427672
Name:LAGUNA NIGUEL MRI INC.
Entity type:Organization
Organization Name:LAGUNA NIGUEL MRI INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:G
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-455-7127
Mailing Address - Street 1:4200 E PACIFIC COAST HWY
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-2112
Mailing Address - Country:US
Mailing Address - Phone:562-498-6322
Mailing Address - Fax:562-597-0978
Practice Address - Street 1:4200 E PACIFIC COAST HWY
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-2112
Practice Address - Country:US
Practice Address - Phone:562-498-6322
Practice Address - Fax:562-597-0978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory