Provider Demographics
NPI:1477616712
Name:ALLIANCE HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:ALLIANCE HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC VP & CFO
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:AIHARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-544-3215
Mailing Address - Street 1:100 BAYVIEW CIRCLE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2984
Mailing Address - Country:US
Mailing Address - Phone:800-544-3215
Mailing Address - Fax:
Practice Address - Street 1:200 E ARIZONA AVE
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:TX
Practice Address - Zip Code:79556-7120
Practice Address - Country:US
Practice Address - Phone:915-235-1701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2014-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1543431-02Medicaid
TXFTX024Medicare ID - Type Unspecified
TX1543431-02Medicaid