Provider Demographics
NPI:1164491304
Name:INSIGHT HEALTH CORP
Entity Type:Organization
Organization Name:INSIGHT HEALTH CORP
Other - Org Name:JEFFERSON IMAGING-BALA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR V.P. & CHIEF ACCOUNTING OFCR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:DRAZBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-282-6000
Mailing Address - Street 1:26250 ENTERPRISE CT
Mailing Address - Street 2:STE 100
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-8406
Mailing Address - Country:US
Mailing Address - Phone:949-282-6000
Mailing Address - Fax:
Practice Address - Street 1:15 PRESIDENTIAL BLVD
Practice Address - Street 2:STE 102
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1006
Practice Address - Country:US
Practice Address - Phone:610-664-3355
Practice Address - Fax:610-664-5266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1012232280002Medicaid
PA087204Medicare ID - Type Unspecified