Provider Demographics
NPI:1629091509
Name:HEALTHPOINTE MEDICAL GROUP, INC,
Entity Type:Organization
Organization Name:HEALTHPOINTE MEDICAL GROUP, INC,
Other - Org Name:(DBA) PACIFIC CARE MRI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ISMAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:562-920-8394
Mailing Address - Street 1:1717 E LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-4345
Mailing Address - Country:US
Mailing Address - Phone:714-635-2642
Mailing Address - Fax:714-635-8547
Practice Address - Street 1:5722 BELLFLOWER BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90713-1422
Practice Address - Country:US
Practice Address - Phone:562-920-8394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG391722471M1202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance ImagingGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFNPOtherFICTITIOUS NAME PERMIT