Provider Demographics
NPI:1598783052
Name:OPEN SYSTEM MRI LLC
Entity Type:Organization
Organization Name:OPEN SYSTEM MRI LLC
Other - Org Name:OPEN SYSTEM IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:O
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:760-346-6413
Mailing Address - Street 1:PO BOX 1595
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270
Mailing Address - Country:US
Mailing Address - Phone:760-346-6413
Mailing Address - Fax:
Practice Address - Street 1:670 RIO LINDA
Practice Address - Street 2:#100
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926
Practice Address - Country:US
Practice Address - Phone:530-342-8121
Practice Address - Fax:530-342-6790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ179792Medicare ID - Type Unspecified