Provider Demographics
NPI:1720295256
Name:OPUS IMAGING
Entity type:Organization
Organization Name:OPUS IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GUNNAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-375-1940
Mailing Address - Street 1:5252 ORANGE AVE
Mailing Address - Street 2:104
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-2967
Mailing Address - Country:US
Mailing Address - Phone:866-375-1940
Mailing Address - Fax:877-816-0721
Practice Address - Street 1:5252 ORANGE AVE
Practice Address - Street 2:104
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-2967
Practice Address - Country:US
Practice Address - Phone:866-375-1940
Practice Address - Fax:877-816-0721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A77092085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty