Provider Demographics
NPI:1538660410
Name:SHIN IMAGING LLC
Entity Type:Organization
Organization Name:SHIN IMAGING LLC
Other - Org Name:SHIN IMAGING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:MALONEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-578-8882
Mailing Address - Street 1:1955 SUNNY CREST DR STE 110
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3653
Mailing Address - Country:US
Mailing Address - Phone:714-578-8882
Mailing Address - Fax:
Practice Address - Street 1:5832 BEACH BLVD STE 104
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-2022
Practice Address - Country:US
Practice Address - Phone:714-578-8882
Practice Address - Fax:714-578-8886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-26
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology