Provider Demographics
NPI:1154654523
Name:PREFFERED DIOGNOSTIC IMAGEING
Entity Type:Organization
Organization Name:PREFFERED DIOGNOSTIC IMAGEING
Other - Org Name:PREFFERED DIOGNOSTIC IMAGEING
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:RADIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:KIRBY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-461-2585
Mailing Address - Street 1:10230 ARTESIA BLVD
Mailing Address - Street 2:SUITE# 100
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-6763
Mailing Address - Country:US
Mailing Address - Phone:562-461-2585
Mailing Address - Fax:562-461-2591
Practice Address - Street 1:10230 ARTESIA BLVD
Practice Address - Street 2:SUITE #100
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706
Practice Address - Country:US
Practice Address - Phone:562-461-2585
Practice Address - Fax:562-461-2591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization