Provider Demographics
NPI:1649740895
Name:DG MEDICAL IMAGING
Entity Type:Organization
Organization Name:DG MEDICAL IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-313-8090
Mailing Address - Street 1:1534 AMBERSWEET ST
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-0722
Mailing Address - Country:US
Mailing Address - Phone:562-290-7644
Mailing Address - Fax:877-832-3334
Practice Address - Street 1:701 E 28TH ST STE 300
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2776
Practice Address - Country:US
Practice Address - Phone:562-427-7800
Practice Address - Fax:562-426-6906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-30
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Single Specialty