Provider Demographics
NPI:1548566144
Name:ISCAN IMAGING LLC
Entity Type:Organization
Organization Name:ISCAN IMAGING LLC
Other - Org Name:ISCAN IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT/OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:NEYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-865-6600
Mailing Address - Street 1:2005 NAGLEE AVE STE 50
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-4801
Mailing Address - Country:US
Mailing Address - Phone:408-865-6600
Mailing Address - Fax:408-865-6612
Practice Address - Street 1:2005 NAGLEE AVE STE 50
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-4801
Practice Address - Country:US
Practice Address - Phone:408-865-6600
Practice Address - Fax:408-865-6612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology