Provider Demographics
NPI:1972751147
Name:CEPIN IMAGING CENTER
Entity type:Organization
Organization Name:CEPIN IMAGING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CEPIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-482-0300
Mailing Address - Street 1:752 MEDICAL CENTER CT STE 103
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-6659
Mailing Address - Country:US
Mailing Address - Phone:619-482-0300
Mailing Address - Fax:619-240-3548
Practice Address - Street 1:752 MEDICAL CENTER CT STE 103
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-6659
Practice Address - Country:US
Practice Address - Phone:619-482-0300
Practice Address - Fax:619-240-3548
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DANIEL CEPIN, M.D.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-29
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG52521261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty