Provider Demographics
NPI:1073738266
Name:VALLEY IMAGING
Entity Type:Organization
Organization Name:VALLEY IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-348-0500
Mailing Address - Street 1:18523 CORWIN RD
Mailing Address - Street 2:SUITE J
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2338
Mailing Address - Country:US
Mailing Address - Phone:310-348-0500
Mailing Address - Fax:
Practice Address - Street 1:18523 CORWIN RD
Practice Address - Street 2:SUITE J
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2338
Practice Address - Country:US
Practice Address - Phone:310-348-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA364882085D0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085D0003XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic NeuroimagingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A364880Medicaid
CA00A364880Medicaid