Provider Demographics
NPI:1568537801
Name:ASSURED MEDICAL IMAGING
Entity Type:Organization
Organization Name:ASSURED MEDICAL IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:J
Authorized Official - Middle Name:RAMON
Authorized Official - Last Name:VILLANUEVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-318-0397
Mailing Address - Street 1:1850 E 17TH ST
Mailing Address - Street 2:SUITE 118
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-8625
Mailing Address - Country:US
Mailing Address - Phone:714-318-0397
Mailing Address - Fax:
Practice Address - Street 1:14600 SHERMAN WAY
Practice Address - Street 2:1ST FLOOR
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-2283
Practice Address - Country:US
Practice Address - Phone:714-318-0397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology