Provider Demographics
NPI:1538427992
Name:SIERRA MEDICAL IMAGING
Entity type:Organization
Organization Name:SIERRA MEDICAL IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:MORTON
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS
Authorized Official - Phone:951-545-3527
Mailing Address - Street 1:1950 COMPTON AVE
Mailing Address - Street 2:SUITE 112
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-6471
Mailing Address - Country:US
Mailing Address - Phone:951-545-3527
Mailing Address - Fax:
Practice Address - Street 1:1950 COMPTON AVE
Practice Address - Street 2:SUITE 112
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-6471
Practice Address - Country:US
Practice Address - Phone:951-545-3527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA292162471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty