Provider Demographics
NPI:1992063531
Name:REGIONAL MEDICAL SERVICES
Entity type:Organization
Organization Name:REGIONAL MEDICAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LANDEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRALLEGRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-986-9857
Mailing Address - Street 1:PO BOX 27128
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92809-0104
Mailing Address - Country:US
Mailing Address - Phone:714-986-9857
Mailing Address - Fax:
Practice Address - Street 1:5824 UPLANDER WAY
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6608
Practice Address - Country:US
Practice Address - Phone:714-986-9857
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)