Provider Demographics
NPI:1407303092
Name:HTC IMAGING
Entity Type:Organization
Organization Name:HTC IMAGING
Other - Org Name:NONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHICK
Authorized Official - Suffix:
Authorized Official - Credentials:TECHNOLOGIST
Authorized Official - Phone:949-466-5200
Mailing Address - Street 1:2232 PORT ABERDEEN PL
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5409
Mailing Address - Country:US
Mailing Address - Phone:949-466-5200
Mailing Address - Fax:
Practice Address - Street 1:2621 SOUTH BRISTOL ST #108
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704
Practice Address - Country:US
Practice Address - Phone:949-466-5200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29165247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty