Provider Demographics
NPI:1073897807
Name:SCANQUEST IMAGING CORP.
Entity Type:Organization
Organization Name:SCANQUEST IMAGING CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:MINJARES
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:562-217-1244
Mailing Address - Street 1:9457 OAK ST
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-5205
Mailing Address - Country:US
Mailing Address - Phone:888-517-1326
Mailing Address - Fax:562-633-6459
Practice Address - Street 1:16415 COLORADO AVE STE 402
Practice Address - Street 2:
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-5052
Practice Address - Country:US
Practice Address - Phone:562-217-1244
Practice Address - Fax:562-633-6459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology