Provider Demographics
NPI:1992844088
Name:MEDICAL CENTER MAGNETIC IMAGING, LLC
Entity type:Organization
Organization Name:MEDICAL CENTER MAGNETIC IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-869-6825
Mailing Address - Street 1:3000 TELEGRAPH AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3218
Mailing Address - Country:US
Mailing Address - Phone:510-869-8777
Mailing Address - Fax:510-893-0332
Practice Address - Street 1:3000 TELEGRAPH AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3218
Practice Address - Country:US
Practice Address - Phone:510-869-8777
Practice Address - Fax:510-893-0332
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUTTER EAST BAY HOSPITALS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-05
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FG666AOtherMEDICARE PTAN - PETCT AND CT
CAP00118317OtherRAILROAD MEDICARE
ZZZ27496ZOtherMEDICARE PTAN - MRI