Provider Demographics
NPI:1659613859
Name:CALIFORNIA MEDICAL IMAGING ASSOCIATES, INC
Entity Type:Organization
Organization Name:CALIFORNIA MEDICAL IMAGING ASSOCIATES, INC
Other - Org Name:CMIA INC
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:
Authorized Official - Last Name:MONIZ
Authorized Official - Suffix:
Authorized Official - Credentials:CPPM
Authorized Official - Phone:800-841-5200
Mailing Address - Street 1:2527 CRANBERRY HWY
Mailing Address - Street 2:
Mailing Address - City:WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02571-1046
Mailing Address - Country:US
Mailing Address - Phone:209-577-9900
Mailing Address - Fax:209-577-1509
Practice Address - Street 1:3610 W. PACKWOOD AVENUE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-5000
Practice Address - Country:US
Practice Address - Phone:209-577-9900
Practice Address - Fax:209-577-1509
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CALFIFORNIA MEDICAL IMAGING ASSOCIATES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology