Provider Demographics
NPI:1598148629
Name:NEW LIFE IMAGING INC.
Entity Type:Organization
Organization Name:NEW LIFE IMAGING INC.
Other - Org Name:NEW LIFE ULTRASOUND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:NOEL
Authorized Official - Last Name:MARCOS
Authorized Official - Suffix:
Authorized Official - Credentials:DMS
Authorized Official - Phone:951-489-9096
Mailing Address - Street 1:25021 MADISON AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-8997
Mailing Address - Country:US
Mailing Address - Phone:951-894-6539
Mailing Address - Fax:
Practice Address - Street 1:25021 MADISON AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-8997
Practice Address - Country:US
Practice Address - Phone:951-894-6539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC3783794291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory