Provider Demographics
NPI:1609378199
Name:VASCULAR IMAGING PROFESSIONALS INC.
Entity Type:Organization
Organization Name:VASCULAR IMAGING PROFESSIONALS INC.
Other - Org Name:VIP IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:LIEBERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-278-5622
Mailing Address - Street 1:1061 N SHEPARD ST STE J
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806-2818
Mailing Address - Country:US
Mailing Address - Phone:949-278-5622
Mailing Address - Fax:877-847-6110
Practice Address - Street 1:1061 N SHEPARD ST STE J
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92806-2818
Practice Address - Country:US
Practice Address - Phone:949-278-5622
Practice Address - Fax:877-847-6110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-01
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7755-302471N0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471N0900XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistNuclear Medicine TechnologyGroup - Single Specialty