Provider Demographics
NPI:1306203666
Name:3G MEDICAL IMAGING
Entity Type:Organization
Organization Name:3G MEDICAL IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:
Authorized Official - Last Name:NIELSON
Authorized Official - Suffix:
Authorized Official - Credentials:RVT
Authorized Official - Phone:805-705-5003
Mailing Address - Street 1:913 LINDENCLIFF ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-2710
Mailing Address - Country:US
Mailing Address - Phone:805-705-5003
Mailing Address - Fax:
Practice Address - Street 1:1400 REYNOLDS AVE STE 110
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-5562
Practice Address - Country:US
Practice Address - Phone:949-502-4164
Practice Address - Fax:949-209-4115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-18
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty