Provider Demographics
NPI:1538700588
Name:CENTRAL VALLEY MEDICAL IMAGING, LLC
Entity Type:Organization
Organization Name:CENTRAL VALLEY MEDICAL IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROGER
Authorized Official - Last Name:SLUSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-425-0778
Mailing Address - Street 1:1187 N WILLOW AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-4411
Mailing Address - Country:US
Mailing Address - Phone:559-425-0778
Mailing Address - Fax:
Practice Address - Street 1:1125 E SPRUCE AVE STE 103
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3385
Practice Address - Country:US
Practice Address - Phone:559-425-0778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology