Provider Demographics
NPI:1164475174
Name:OPEN AIR MRI CENTERS MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:OPEN AIR MRI CENTERS MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROBINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-229-2299
Mailing Address - Street 1:PO BOX 910514
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92191-0514
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6386 ALVARADO CT
Practice Address - Street 2:107
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-4905
Practice Address - Country:US
Practice Address - Phone:619-229-2299
Practice Address - Fax:619-229-2288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Not Answered2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ06139ZOtherBLUE SHIELD
ZZZ06141ZOtherBLUE SHIELD
ZZZ06142ZOtherBLUE SHIELD
ZZZ06136ZOtherBLUE SHIELD
ZZZ6140ZOtherBLUE SHIELD
ZZZ06137ZOtherBLUE SHIELD
ZZZ06138ZOtherBLUE SHIELD
W16103Medicare ID - Type Unspecified